Upper-airway cough syndrome (postnasal drip)?,”A patient’s cough that started after a recent URI, that occurs primarily at night, and is without expectoration is most consistent with upper-airway cough syndrome (postnasal drip). In some patients, postnasal drip can be “”silent”” without the classic presentation (eg, liquid dripping into the back of the throat, frequent throat clearing). The best diagnostic approach is to treat empirically with an oral first-generation antihistamine (eg, chlorpheniramine) or combined antihistamine-decongestant (eg, brompheniramine and pseudoephedrine). Patients who do not respond after 2-3 weeks may require further investigation (eg, PFTs, Chest x-ray, CT of the chest) or empirical sequential therapy for GERD, cough-variant asthma, chronic sinusitis

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Disseminated gonococcal infection?,”Disseminated gonococcal infection often presents with a triad of polyarthralgias (eg, wrist, elbow, and ankle pain), tenosynovitis (along tendon sheaths), and vesiculopustular skin lesions.A history of recent unprotected sex with a new partner is frequently associated with disseminated gonococcal infection

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Ethylene glycol poisoning in homeless?,”Ethylene glycol is associated with hypocalcemia and calcium oxalate deposition in the kidneys. This leads to flank pain, hematuria, oliguria, AKI, and anion gap metabolic acidosis. Treatment involves administration of fomepizole or ethanol to inhibit alcohol dehydrogenase, sodium bicarb to alleviate the acidosis

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Tricyclic antidepressants (TCA) overdosed?,”TCA overdose can cause hyperthermia as well as other anticholinergic effects, including dilated pupils and intestinal ileus. It can also cause seizures. TCA overdose decreases myocardial conduction velocity, leading to QRS prolongation and risk of ventricular arrhythmia. The major cause of mortality of TCA overdose is believed to be secondary to TCA-induced hypotension. In cases of hypotension, QRS prolongation, and ventricular arrhythmia, sodium bicarbonate is administered. Sodium bicarbonate improves systolic blood pressure

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Basal cell carcinoma (BCC)?,”BCC is the most common of skin cancers in the United States, accounting for ~ 75% of all skin cancers. Features of BCC can include:-Persistent open sore that bleeds, oozes, or crusts-Reddish patch or irritated area -Pearly or translucent nodule with pink, red, or white color- Elevated or rolled border with central ulceration-Pale scar-like area with poorly define bordersThe cancer usually remains local and only rarely spreads to distant parts of the body, but it may continue to grow and invade nearby tissues and structures, including nerves, bones, and brain. Mohs micrographic surgery is employed more often for the face. Mohs surgery is characterized by sequential removal of thin skin layers with microscopic inspection to confirm that the margins have been cleared of malignant tissue. This technique currently has the highest cure rate for BCC and provides the least disruption to surrounding tissues, making it ideal for delicate or cosmetically sensitive areas (eg, perioral region, lips

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Chronic hepatitis C?,”Chronic hepatitis C can be asymptomatic or present with fatigue and nonspecific symptoms (eg, arthralgias, myalgias). Patients usually have waxing and waning elevations of transaminase levels. Extrahepatic sequelae can include essential mixed cryoglobulinemia (circulating immune complexes that deposit in small to medium vessels), porphyria cutanea tarda (fragile skin, photosensitivity, and vesicles and erosions on the dorsum of the hands)

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