Article
Which drugs are best when aggressive Alzheimer’s patients need medication?
- Author:
- Brice Labruzzo Mohundro, PharmD
- Karla Pope, MD, MHSA
- Vincent Shaw, MD
- Kristin Hitchcock, MSI
EVIDENCE-BASED ANSWER: ATYPICAL ANTIPSYCHOTICS ARE EFFECTIVE; so are selective serotonin reuptake inhibitors (SSRIs), and they may be safer....
Article
What does the evidence tell us about treating very-high-risk patients to an LDL <70 mg/dL?
- Author:
- Carrie Nelson, MD, MS
- Kristin Hitchcock, MSI
- James A. Bohlen, MLS
Evidence-based answer: Not much. No studies directly compare low-density lipoprotein (LDL) levels <70 mg/dL to levels of 71 to 100 mg/dL in...
Article
Which treatments are effective for cervical radiculopathy?
- Author:
- Sara Brown, DO
- Rick Guthmann, MD
- Kristin Hitchcock, MSI
EVIDENCE-BASED ANSWER: Initial treatment options comprise rest, cervical immobilization, anti-inflammatory drugs (nonsteroidal and steroidal),...
Article
Should you treat carriers of pharyngeal group A strep?
- Author:
- Dan Sepdham, MD
- Shobha Rao, MD
- Kristin Hitchcock, MSI
EVIDENCE-BASED ANSWER: The jury is out as to whether you should treat asymptomatic carriers of group A streptococci (GAS), because no studies...
Article
How do you evaluate macrocytosis without anemia?
- Author:
- Robert C. Oh, MD, MPH
- Naomi S. Holt, MD
- Kristin Hitchcock, MSI
EVIDENCE-BASED ANSWER: Start with a detailed history, paying particular attention to medications and alcohol use (strength of recommendation [SOR...
Article
How should you evaluate elevated calcium in an asymptomatic patient?
- Author:
- Bikas Sharma, MD, MPH
- Nancy E. Misicko, MD, MPH
- Kristin Hitchcock, MSI
EVIDENCE-BASED ANSWER: First, establish that true hypercalcemia exists by repeating the serum calcium and measuring or calculating the...
Article
What steps can reduce morbidity and mortality caused by hip fractures?
- Author:
- Michael Grover, DO
- Frederick Edwards, MD
- Kristin Hitchcock, MSI
EVIDENCE-BASED ANSWER: Surgery within 24 hours of hip fracture is a critical step in reducing complications, and may decrease mortality compared...
Article
How should you treat Candida vaginitis in patients on antibiotics?
- Author:
- Jinping Xu, MD, MS
- Kendra Schwartz, MD, MSPH
- Kristin Hitchcock, MSI
EVIDENCE-BASED ANSWER: Oral and intravaginal antifungals for the treatment of uncomplicated vulvovaginal candidiasis (VVC) have similar...
Article
Which oral antifungal is best for toenail onychomycosis?
- Author:
- Jose R. Hinojosa, MD
- Kristin Hitchcock, MSI
EVIDENCE-BASED ANSWER: Terbinafine, 250 mg taken daily for 12 weeks, is the best regimen for toenail onychomycosis due to better clinical and...
Article
What’s the best diagnostic evaluation of night sweats?
- Author:
- Cindy W. Su, MD
- Sean Gaskie, MD
- Kristin Hitchcock, MSI
EVIDENCE-BASED ANSWER: There is no single best evidence-based approach to the diagnostic evaluation of night sweats, given the limited number of...
Article
History, exam, and labs: Is one enough to diagnose acute adult appendicitis?
- Author:
- Erik Richardson, DO
- Christopher P. Paulson, MD, FAAFP
- Kristin Hitchcock, MSI
EVIDENCE-BASED ANSWER: No, none of the 3—history, exam, or labs— is sufficiently accurate to diagnose acute appendicitis (strength of...
Article
Can you differentiate bacterial from viral pediatric infections based on the CBC?
- Author:
- Mark Stephens, MD
- Wayne Robert Smith, DO
- Kristin Hitchcock, MSI
EVIDENCE-BASED ANSWER: No—the complete blood count (CBC) alone does not have adequate sensitivity or specificity to tell bacterial from viral...
Article
Are there big differences among beta-blockers in treating essential hypertension?
- Author:
- Daniel Sontheimer, MD, MBA
- Kristin Hitchcock, MSI
EVIDENCE-BASED ANSWER: Yes, a number of beta-blockers are effective in lowering blood pressure (strength of recommendation [SOR]: A, multiple,...
Article
What other STI testing should we do for a patient with chlamydia?
- Author:
- Minal Patel, MD
- Jane E. Corboy, MD
- Kristin Hitchcock, MSI
EVIDENCE-BASED ANSWER: Testing for gonorrhea is recommended for a patient with genital chlamydia; also test for gonorrhea and chlamydia in their...
Article
What is the role of combination therapy (insulin plus oral medication) in type 2 diabetes?
- Author:
- Staci Eskesen, MD
- Gary Kelsberg, MD
- Kristin Hitchcock, MSI
EVIDENCE-BASED ANSWER: Combination therapy using insulin plus metformin (Glucophage), a sulfonylurea, or both produces glycemic control comparable...