The American Heart Association/American Stroke Association recommends a water swallow test performed at the bedside by a trained observer as the best bedside predictor of aspiration. ... A prospective study of the water swallow test demonstrated a
The following cases and commentary, which address sepsis, are excerpted from ACP's Medical Knowledge Self-Assessment Program (MKSAP14).. A 67-year-old man is receiving mechanical ventilation for acute respiratory distress syndrome. He underwent
The following cases and commentary, which address rheumatology, are excerpted from ACP's Medical Knowledge Self-Assessment Program (MKSAP14).
L), reticulocyte count 12% of erythrocytes, total bilirubin 2.8 mg/dL (47.9 µmol/L), direct bilirubin 0.6 mg/dL (10.26 µmol/L), direct antiglobulin (Coombs test) positive ... The relationship between an abnormal screening coagulation test and the risk
The patient is administered empiric therapy with dexamethasone, vancomycin, ceftriaxone, ampicillin, and acyclovir pending additional test results. ... Results of standard laboratory studies are normal. Which of the following is the most appropriate next
A 72-year-old, 90-kg (198-lb) woman who lives in an assisted living facility is evaluated after 10 days in the intensive care unit. She was admitted with severe urosepsis... and other cases.
Guidelines recommend CT or MRI as the preferred diagnostic test in symptomatic patients. ... This diagnostic test also is invasive and costly and is of higher yield when used to evaluate for unusual causes of cardiac emboli, such as valvular endocarditis
A rapid HIV test is positive. Sputum Gram stain shows few neutrophils, pseudohyphae, and mixed bacteria. ... This patient with known HIV risk factors and a reactive rapid HIV test very likely has HIV infection, although confirmation with Western blot
antibodies, positive; serologic test for HIV antibodies, negative; and urinalysis, 2+ protein, 1+ blood, 15 erythrocytes/hpf.
Gastric biopsies are taken to test for Helicobacter pylori. The patient is examined 24 hours after admission. ... acute pancreatitis, or (2) in a patient with gallstone pancreatitis who is not improving clinically and has worsening liver chemistry test