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"What's Your
Diagnosis?"
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This month's challenge was from the latest issue of Emergency
Medicine Practice, "Renal Calculi: Emergency Department
Diagnosis And Treatment."
Read the conclusion and find out who won this month's challenge
at the "What's
Your Diagnosis?" blog!
To receive a free portion of the issue, check out the
Risk-Management Pearls from the issue below.
This month's issue brings you the latest evidence for renal
calculi emergencies and guides you step-by-step from diagnosis to
treatment.
To learn more about Emergency Medicine Practice and how
you can benefit from evidence-based diagnosis and treatment
recommendations like the ones found in this month's issue, visit http://www.ebmedicine.net/EMPinfo
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Abstract:
Renal Calculi
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The acute
treatment of kidney stones (urolithiasis) addresses pain
management and focuses on the effects of the morbidity associated
with an obstructed renal system. Minimal fluid intake, resulting
in decreased urine production and a high concentration of stone-forming
salts, is a leading factor in renal calculi development.
Radio-opaque calcareous stones account for 70% to 75% of renal
calculi. Microscopic hematuria in the presence of acute flank
pain is suggestive of renal colic, but the absence of red blood
cells does not exclude urolithiasis. Furthermore, many
inflammatory and infectious conditions cause hematuria,
demonstrating the low specificity of urinalysis testing. The
diagnostic modality of choice is a noncontrast computed
tomography (CT); ultrasonography is preferred in pregnant
patients and children. Combining opioids with non-steroidal
anti-inflammatory drugs (NSAIDs) is the optimal evidence-based
regimen to treat severe symptoms. Rapid intravenous (IV)
hydration has not shown a benefit. Potentially life-threatening
diagnoses including abdominal aortic aneurysm, ovarian torsion,
and appendicitis may mimic renal colic and must be ruled out.
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Risk
Management Pitfalls For Renal Calculi
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Risk management is an important part of being an
emergency clinician. With these Risk Management Pitfalls For
Renal Calculi, you'll have a quick reference guide to help you
avoid some of the most common mistakes.
Click here to
download your FREE copy of this month's Risk Management Pitfalls.
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Thanks again to everyone that participated in this
month's "What's Your Diagnosis?" challenge. And
congratulations to the winners of the latest issue of Emergency
Medicine Practice.
If you haven't already, check out the conclusion at the "What's
Your Diagnosis?" blog.
I hope you enjoyed this month's challenge! See you
next month with a new challenge and more chances to win.
Kindest Professional Regards,
Andy Jagoda, MD, FACEP
Editor-In-Chief of EB Medicine's Emergency
Medicine Practice
P.S. To read the abstract from this month's issue, click here.
P.P.S. To learn more about Emergency Medicine Practice and
how you can benefit from evidence-based diagnosis and treatment
recommendations, visit http://www.ebmedicine.net/EMPinfo
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