Category: Pulmonary/Critical Care

Clinical Correlations


Spotlight: A case of Metformin Associated Lactic Acidosis

By  Jasmine Nee and Martin Fried, MD

Peer Reviewed

LEARNING OBJECTIVES

1. What is metformin-associated lactic acidosis?
2. How does severe acidemia lead to acute kidney injury?
3. How do you treat metformin-associated lactic acidosis?

CASE SUMMARY

The patient is a 40-year-old man with alcohol dependence and type II diabetes who presented to the emergency department for alcohol intoxication.…

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Is There Really a Link between Asthma and Reflux?

By Scott Statman, MD

Peer Reviewed

There is little doubt that an association between asthma and gastroesophageal reflux disease (GERD) exists. However clinicians have debated the nature of this relationship for decades. Asthma and GERD are among the most common disorders encountered by physicians, with prevalence in the general population estimated at 8%1 and 10 to 20%2 respectively.…

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What is the Evidence for Noninvasive Ventilation in Acute Cardiogenic Pulmonary Edema?

cardiologyBy Jenna Conway, MD

Peer Reviewed

Introduction 

A 58-year-old man presents with worsening dyspnea and nonproductive cough for five days. Significant history includes a recent hospitalization for congestive heart failure. He is afebrile with a blood pressure of 95/55 mmHg, heart rate of 115 beats per minute, and oxygen saturation of 85% on room air.…

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Diagnostic Challenges in Latent Tuberculosis Infection: A Brief Review of Available Tests and their Appropriate Use

Tuberculosis_symptomsBy: Miguel A. Saldivar, MD

Peer Reviewed 

“Indeterminate.” Many clinicians have expressed frustration when reading this word on a Quantiferon-TB Gold test result. The obligate follow-up question is: what is the next best step? Repeat the Quantiferon? Ignore it altogether and perform a Tuberculin Skin Test (TST) instead?…

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Lung Cancer Screening with Low-Dose CT Scans

By Susanna Jeurling

Peer Reviewed

The U.S. Preventive Services Task Force (USPSTF) recently finalized its position regarding annual low-dose computed tomography (LDCT) scanning for early detection of lung cancer. The grade B recommendation states that individuals between the ages of 55 and 80 with a 30 pack-year history or more of smoking who are current smokers or who have quit within the last 15 years should undergo annual LDCT screening, based on the results of the National Lung Screening Trial [1].…

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