Alternate Common/Unique Diagnosis: Difference between revisions
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==Outpatient== | ==Outpatient== | ||
* [[Practicing Medicine in Bush Alaska—Some ABCs#Cellulitis -- Community acquired MRSA Abscesses]] | * [[Practicing Medicine in Bush Alaska—Some ABCs#Cellulitis -- Community acquired MRSA Abscesses]] | ||
* [[Pharyngitis]] | * [[Pharyngitis]] | ||
* [[Peritonsillar Abscess]] | * [[Peritonsillar Abscess]] | ||
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* [[Sinusitis More Than 5 Years]] | * [[Sinusitis More Than 5 Years]] | ||
* [[Chronic Cough/Bronchiectasis – Pediatrics]] | * [[Chronic Cough/Bronchiectasis – Pediatrics]] | ||
* [[Varicella]] | * [[Varicella]] | ||
* [[Dyspepsia – H. Pylori]] | * [[Dyspepsia – H. Pylori]] | ||
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* [[Congestive Heart Failure]] | * [[Congestive Heart Failure]] | ||
* [[Hypertension]] | * [[Hypertension]] | ||
* [[media:Osteoporosis_Screening_and_Treatment.pdf|Osteoporosis Screening and Treatment]] | * [[media:Osteoporosis_Screening_and_Treatment.pdf|Osteoporosis Screening and Treatment]] | ||
* [[Breast Cancer Screening]] | * [[Breast Cancer Screening]] | ||
* [[Attention Deficit Hyperactivity Disorder in Children]] | * [[Attention Deficit Hyperactivity Disorder in Children]] | ||
* [[Lead Evaluation – Pediatrics | * [[Lead Evaluation – Pediatrics|Blood Lead levels (Pediatric)]] | ||
==Abdominal pain== | ==Abdominal pain== | ||
Revision as of 10:52, 24 September 2020
Practicing Medicine in Bush Alaska—Some ABCs
Emergency and Outpatient Departments
- Acute Myocardial Infarction
- Skin and Soft Tissue Infection
- UTI – Adult
- UTI – Children 3 Months–5 Years
- Seizures (Pediatric)
- Tuberculosis (Active and LTBI)
- Amoxicillin Allergy Trials
Emergency Department
- High-Flow Nasal Cannula
- Acute Ischemic Stroke
- Sepsis (Adult)
- Sepsis (Pediatric)
- Fever (0-90 days)
- Influenza
- Pneumonia (Adult)
- Procalcitonin (PCT) in Adult Lower Respiratory Tract Infections
- Pneumonia (Pediatric)
- Croup/Stridor
- Bronchiolitis/Wheezing
- Head Injury / Concussion Under 18 Years
- First Trimester Vaginal Bleeding
- Frostbite
- Burn Evaluation and Treatment
- Rabies
- Acetaminophen Overdose
- Alcohol Hangover/Withdrawal
- Title 47 Hold
- Botulism
- Fish Finger
Neonatal
Pediatric
- CPT1A Arctic Variant
- Congenital Adrenal Hyperplasia (CAH)
- Congenital Sucrase-Isomaltase Deficiency (CSID)
- Haemophilus influenza type a (Hia)
- Kuskokwim Syndrome (Arthrogryposis-like syndrome)
- Metachromatic Leukodystrophy (MLD)
- Micro-aspiration (in Apparently Neurologically Typical Children)
- Rickets and Vitamin D Deficiency
- Septo Optic Dysplasia
- Septic Joint
Obstetrics
- First Trimester Vaginal Bleeding
- Ectopic Pregnancy
- Preterm Labor
- Gestational Diabetes
- Group B Streptococcus (GBS) – Maternal
- Molar Pregnancy
- Anemia in Pregnancy
- Anti-D Immune Globulin
- Intrauterine Growth Restriction (IUGR)
- Oligohydramnios
- Intrahepatic Cholestatis of Pregnancy (IHCP)
- Chronic Hypertension in Pregnancy
- Gestational Hypertension
- Preterm Premature Rupture of Membranes
- Vaginal Birth After Cesarian
Outpatient
- Practicing Medicine in Bush Alaska—Some ABCs#Cellulitis -- Community acquired MRSA Abscesses
- Pharyngitis
- Peritonsillar Abscess
- Acute Cervical Lymphadenitis Evaluation & Treatment – Pediatrics
- Acute Otitis Media
- Sinusitis More Than 5 Years
- Chronic Cough/Bronchiectasis – Pediatrics
- Varicella
- Dyspepsia – H. Pylori
- Type 2 Diabetes
- Congestive Heart Failure
- Hypertension
- Osteoporosis Screening and Treatment
- Breast Cancer Screening
- Attention Deficit Hyperactivity Disorder in Children
- Blood Lead levels (Pediatric)
Abdominal pain
- This is another very common reason for a visit to the ED. Most of our patients do not have access to fresh fruits and vegetables and reliable safe drinking water and therefore constipation is very common. The nursing staff has standard orders for triage for this problem. We do not have surgeons in Bethel (except for OB related issues) and so all appys need to travel to Anchorage if the surgeon wants to take out the appendix. They can often travel in on a commercial flight if they are stable. If unstable, or if pain can’t be controlled, they will need a medevac.
Injuries/Fractures
- Please send all x-rays with fractures diagnosed to ANMC orthopedic telerad. This is a paper form you must complete. That allows for non-urgent consultation to take place via the ambulatory clinic. If there is an urgent need, please call ANMC and speak to the on-call ortho doc. They can give you some advice over the phone and, during the day, look at your x-rays.
- If the patient is a trauma victim, call ANMC surgeon on call. They handle all calls related to trauma, even if the primary injury is orthopedic.
Hepatitis B
Hepatitis B is common here with the probable major mode of transmission being sexual or close contact. There is a high carrier rate and the “Hepatitis B” program does an excellent job in following AFPs and LFTs to screen for hepatomas bi-annually in these carriers. Children not vaccinated at birth and all Alaskans and health care workers working in Alaska should receive the three part vaccination. Pregnant women who are carriers need to have their HepBeAg tested. If it is positive the child at birth should get the Hep B immunization as well as the immunoglobulin. If the mother is just HepBsAg positive – they do not get the immunoglobulin. If the mother is just HepBsAg positive—they do not get the immunoglobulin—Epidemiology per our State recommendations.
Resources:
HLA-B27
This is frequent in this population with all of its associations (Reiters syndrome, Rheumatoid arthritis, and spondyloarthropathies are much more common here. We manage patients with rheumatic arthritis on Methotrexate with the assistance of ANMC specialist. Remember the labs that need to be done Q 1-2 months – kidney, liver, and blood count – CBC and Comp Chem.
