Causes: Bacterial infection is the most common cause of endocarditis, specifically viridans group strep, Staphylococcus aureus, HAECK group organisms (Haemophilus species, Aggregatibacter actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, and Kingella kingae), or Enterococcus. Endocarditis can also be caused by fungi, such as Candida. Some weird fastidious bacteria show up too, like Bartonella, Brucella, Coxiella burnetii (causes […]
Guideline Materials and Tips
Sinus Troubles: When Should I See My Doctor
We’ve all had sinus troubles before and it’s sometimes hard to tell if it’s a bacterial infection, a virus, or allergies. Your physician probably even has a hard time. Here are some tips on when to see your physician, and when you should visit your local pharmacy for some home remedies. Viral Sinusitis If you’ve […]
Common Pharmacogenomic SNPs and Interactions
UM = ultrarapid metabolizer, EM = extensive metabolizer, IM = intermediate metabolizer, PM = poor metabolizer Drug SNP Types Effect Race Misc Ivacaftor CFTR amitriptyline CYP 2C19 UM (R), EM, IM, PM PM = increased conc, side effects, UM = decreased concen PM =Common in Asians UM=Common in Caucasions […]
Pneumonia
Community Acqired Pneumonia (CAP) CAP is usually caused by S. pneumonia, H. influenza, S. aureus, legionella (usually more severe), mycoplasma and Chlamydophila (less severe), and pseudomonas and Enterobacteriaceae sometimes isolated You don’t usually do cultures in CAP. Chest infiltrate and cough/sputum are diagnostic. Don’t go by procalcitonin to diagnose or to discontinue therapy. For CAP, there are a […]
COPD and Bronchitis
Chronic obstructive pulmonary disease (COPD) causes a significant amount of morbidity and mortality. It’s the fourth leading cause of death in the world. COPD produces anatomical changes in the lungs that lead to narrowing of small airways, destruction of lung tissue, overproduction of mucous, reduced ciliary function, and airflow limitation. Smoking is the most common […]
COVID-19 mRNA EUA Vaccine FAQs
There have been a lot of questions about the COVID-19 mRNA vaccines. I thought I would put together an easy FAQ with some referenced answers. I’ll keep adding to it as I get more questions. I have a FAQ about the Johnson and Johnson vaccine too. Is it Going to Alter my DNA? If you […]
Asthma
Asthma is pretty common. Over 25 million people in the US have it, and over 3500 people died from it in 2017. Hispanics and blacks suffer disproportionately. It’s a disease of chronic airway inflammation causing expiratory limitations including wheezing, chest tightness, shortness of breath, and cough. It can be spontaneous or triggered by exercise, allergens […]
Clostridium/Clostridiodes Difficile
Clostridiodes difficile is a pretty big problem, causing quite a bit of morbidity and mortality every year, and it’s becoming more and more common. It can be pretty tricky to treat. C. diff is an anaerobic, spore-forming rod and it makes a toxin that contributes to the severity of the disease. It causes diarrhea and […]
Sinusitis
Sinusitis is usually viral. Only use antibiotics if signs and symptoms are greater than 10 days or purulent discharge with a fever greater than 102 degrees. Viral is quick, usually lasting less than a week. Bacterial often has double sickening and purulent discharge. Do not do imaging unless immunocompromised or orbital cranial involvement. Only symptomatic relief for […]
Guideline Notes
Anything marked guidelines are my BCPS study notes that I try to keep updated (I update a new section every few months). That being said, some of the data is not up to date and it should not be used for clinical purposes. I thought I would make it public because it might help someone […]