The new issue of AFP is out but my back is too beat up to sit and write :( But I will try out this iPhone app while I am on the pt bed..... I've been listening to the medscape family medicine podcasts but they are real short. They mentioned that in urinalysis, pay attention to albumin (AKA micro-albumin) because it is a good index of cardiovascular health. If a pt has hypertension and glomerular disease, you can consider using verapamil and diltiazam because it causes dilation of the pre and intra glomerular vessels, similar to and ACEI or ARB.
In peripheral vessel disease, classic claudication is only seen in 10% of patients with claudication so be aware of atypical symptoms. ABI is a very good test to do if you are suspicious. You can give them a statin even if their lipid levels aren't that high. There is also some other medication that starts with an "S" and ends with an "L" that you can use. It is also effective to give them an exercise regiment where they walk till they have pain, continue a little more, then take a break and continue when the pain subsides. They should do about 30-45 minutes 4-5 times a day.
Hmm what else... Oh yeah, ticks can also spread a parasite called nabezia(?) which can be seen on a blood smear. In a lipid panel, non-HDL cholesterol is a more important (and cheaper) index than apoE and ... I forgot the other index. Whooping cough is on the rise in Colorado...
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