ashpt, Author at Physical Medicine and Rehabilitation Qbank Review

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So far ashpt has created 12 blog entries.

Diagnostic Musculoskeletal Ultrasound

Diagnostic Musculoskeletal Ultrasound PM&R News • April 2022 Ultrasound for the diagnosis of musculoskeletal pathology is becoming increasingly widespread. However, many clinics still do not have a standardized method for documenting diagnostic ultrasound procedures. We have generated several basic diagnostic ultrasound templates for use by Physiatrist to assist with appropriate documentation that can communicate findings, and help providers capture charges for work performed in the assessment of the patient. Please see these templates as listed below: Limited Diagnostic Ultrasound of the ***, Performed by Dr. *** during their clinic visit on **/**/**** A 2D, gray scale B mode ultrasound limited ultrasound of the *** [...]

Diagnostic Musculoskeletal Ultrasoundashpt2022-04-25T01:40:54+00:00

Multiple Myeloma

Multiple Myeloma PM&R News • August 2021 Anatomy Blood: Immunoglobulin-producing Plasma cells (derived from B cells; a lymphocyte sub-type) Pathophysiology Plasma cells: neoplastic proliferation → monoclonal immunoglobulin Proliferation in the bone marrow = skeletal destruction Epidemiology U.S.: 1 – 2% of all cancers > 17% of hematologic malignancies Annual: 4-5/100,000 Worldwide: 160,000 cases 106,000 deaths/year Risk factors: Ethnicity: African Americans 2-3x > Caucasians Lowest risk: Asians from Japan, Mexicans Increased incidence: Males > females (1.4:1), ↑ BMI, older age (avg: 66 y/o), 1st degree relative (3.7x), variation of the 3p22.1 or 7p15.3 genetic loci Presentation/ Clinical Manifestations Anemia: 73% at diagnosis; 97% at some [...]

Multiple Myelomaashpt2021-08-18T14:49:13+00:00

Blood Pressure Management in Stroke

Blood Pressure Management in Stroke PM&R News • June 2021 Goals: A balance of cerebral perfusion and ischemia BP <140/90 mmHg Antihypertensives restarted in neurologically stable patients ~24-48 hrs UTD recommendation: after large artery stenosis is excluded and after vascular imaging performed For large artery: timeframe is 7-14 days Timeframe goal: few days – few weeks Ischemic rtPA not administered: do not lower BP in first 24 hrs unless it exceeds 220/120 OR active: ischemic coronary disease, heart failure, aortic dissection, hypertensive encephalopathy, or pre-eclampsia/eclampsia Prior to rtPA administration: BP <185/110 After rtPA administration: BP < 180/105 for 24 hours. Monitoring: 1st 2 [...]

Blood Pressure Management in Strokeashpt2021-06-19T23:21:57+00:00

Anticoagulation for Atrial Fibrillation

Anticoagulation for Atrial Fibrillation PM&R News • April 2021 Purpose: To lower the risk of thromboembolism in patients with atrial fibrillation (A-fib). Risk reduction: ~70-75% However, risk of severe bleeding: 0.2-0.4% risk/year (MC severe site: intracranial hemorrhage, ICH) Lower than the risk of ischemic stroke in those with Afib AF: determined via electrodiagnostic studies à EKG “Irregularly, irregular” → RR intervals do not follow a pattern [Usually] no definite P waves If defined, P-P Interval is not regular; <200ms (atrial rate > 300 bpm) Epidemiology S.: 3.03 million (2005); projected by 2050: 5.6-7.56 million (50%: > 80 y/o) Worldwide: 33.5 million (2010) Risk [...]

Anticoagulation for Atrial Fibrillationashpt2021-04-28T01:45:26+00:00

Neuroimaging

Neuroimaging - A Review PM&R News • March 2021 Imaging Description Pros Cons Identifies/Utilized in the following: CT (computed tomography) head w/o contrast Analyzes residual radiation waves emitted from the body via a radiographic tube that is rotated axially. Utilizes mathematical algorithms of images to reconstruct a cross-sectional image. Fast Not sensitive to motion Widely available Primary choice: acute/emergent situations Radiation exposure = increased lifelong risk of cancer (minimal) “may impair long-term cognitive function”(UTD) Identifies calcifications Hemorrhagic CVA Intracranial hematoma (<12 hrs) Infraction Bony/air space abnormalities Edema, herniations, fx, hypoxic-ischemia injury, mass, hydrocephalus ASPECTS score: assists to determine tx Superior over MRI [...]

Neuroimagingashpt2021-04-22T02:51:15+00:00