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When to Refer a Patient to a Physician

Pediatric patients should be referred to physicians if any of the following symptoms are present: skin rash chronic cough “bark like” cough stridor hoarseness constant ear pain or pulling/tugging at ears seizure or convulsion recently rapid or difficulty breathing severe abdominal pain or cramping diarrhea > 2 days vomiting > 12 hours infant not feeding … Continue reading

Abuse, Addiction and Dependence

Addiction:  a primary, chronic, neurobiological disease with genetic, psychosocial and environmental factors with influence its development and manifestations.  It is characterized by behaviors that include decreased control over drug use, complusive use, continued use despite harm and/or craving. Physical Dependence:  a state of adaptation that is manifested by a drug-class-specific withdrawal syndrome that can be … Continue reading

Triggers of Anaphylaxis

Common triggers of anaphylaxis are outlined below based on whether they are immunologically or non-immunologically based. Immunological IgE-mediated Animal dander Rubber latex Occupational allergens (ex. dust) Insect venom (ex.  bee stings) Foods (ex. Milk, fish, eggs, peanuts) Medications (ex.  Vaccines, penicillins, sulfa drugs) IgE-independent Contrast dye Blood products (ex. Immunoglobulin) Medications (ex. ACE inhibitors, ARBs) … Continue reading

Considerations for Epilepsy Treatment in Pediatrics

Age Insurance Comorbidities (particularly ADHD, cerebral palsy, autism, mental retardation, migraines and being conscious of the drug-drug interactions that may be associated with the meds being used to treat those conditions) Correct diagnosis of seizure disorder (seizure type and EEG findings if applicable) Side effect profile of antiepileptic Medication administration considerations (ex. tabs vs. liquids; … Continue reading

Dietary Gluten

Common Sources of Gluten in the Diet: Malt containing products (ex. Malt vinegar) Rye Matzo Wheat Couscous Breading Barley Flour Brown Rice Syrup Seasoned chips Seasoned Nuts Hot dogs Salami Sausage Processed lunch meats Imitation meats (ex. Bacon, seafood, etc) Rice Pilaf Drink mixes Beer Croutons Some medications/vitamins/supplements Energy bars Dairy substitutes Marinades Sauces/gravies Salad … Continue reading

Overactive Bladder

Overactive bladder is a disease which can result from several different etiologies but is primarily characterized by a hyperactive bladder wherein affected individuals feel a frequent urge to urinate and may also experience spontaneous urine loss. Antimuscarinics are the traditional first-line therapy for treatment.  Any antimuscarinic should be tried for at least two weeks to … Continue reading

Pain Pathophysiology Overview

Receptors involved in pain modulation: opioid receptors alpha-2 adrenergic receptors voltage-gated calcium channels NMDA receptors Chemical mediators (sensitize neurons to pain): substance P prostaglandins bradykinin glutamate Neurotransmitters (facilitate pain modulation): norepinephrine serotonin GABA

Overview of Types of Pain

acute pain: < 1 month in duration chronic pain:  > 6 months in duration can arise from nociceptive and/or neuropathic origins Nociceptive pain:  experienced in the presence of an injury or trauma.  Can be described as sharp, dull, or achy and may either be localized or diffuse. examples include: osteoarthritis and pancreatitis. Neuropathic pain: pain … Continue reading

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