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Was the test used specific for glucose? Glucose oxidase tests (Clinistix, etc.) are specific for glucose, whereas other tests (Benedict's, etc.) are not. Thus, the latter will give false positives for lactose, fructose, galactose, and salicylates. ... DIAGNOSTIC WORKUP
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What is the free T
4
? If this is elevated, think of hyperthyroidism.
What is the plasma cortisol? If this is elevated, think of Cushing's syndrome.
What is the plasma growth hormone? If this is ... DIAGNOSTIC WORKUP
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Is there redness of the eye? Redness of the eye suggests definite eye pathology. Without redness, one should suspect disease in the adjacent structures or retrobulbar neuritis.
If there is ... DIAGNOSTIC WORKUP
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Normal fasting glucose is <110 mg/dL, impaired fasting glucose is 111–125 mg/dL, and diabetes mellitus is defined as a fasting glucose >126 mg/dL. Several values above normal are indicated before making a diagnosis of impaired fasting glucose or diabetes.
... Workup and Diagnosis ... Treatment
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A red eye is a diagnostic sign of ocular inflammation, which may be caused by a multitude of conditions. Most cases are benign and can be effectively managed by the primary care physician. Misdiagnosis of the more emergent conditions can have major vision-threatening complications;... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Diabetes mellitus is the most common endocrine disorder of childhood, affecting about 2/1,000 school-age children in the U.S. The absolute or relative lack of insulin results in an abnormal metabolic state, including hyperglycemia. Children with diabetes are at risk for the acute... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Red eye is a “basket” term that encompasses a wide range of ophthalmic conditions. Most conditions are self-limited; however, red eye can be a sign of serious eye disease. Presence of pain helps to distinguish between the more... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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The most common cause of eye discharge in pediatric patients is viral conjunctivitis. Many clinicians treat viral conjunctivitis as bacterial conjunctivitis because the similarities in history and physical examination make a definitive diagnosis difficult without a culture, which... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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... The finding of glycosuria should prompt one to consider first the conditions that are associated with faulty regulation of the blood sugar and sugar metabolism. First and foremost on that list is diabetes mellitus. However, the differential must
... READ EXCERPTS »
... To form a list of diagnostic possibilities in a case of hyperglycemia, one needs only to think of the endocrine glands. Considering the pancreas should prompt the recall of diabetes mellitus and glucogonomas. Considering the adrenal gland would prompt the
... READ EXCERPTS »
... Applying the mnemonic MINT to the various anatomic parts of the eye will aid in systematically developing a list of diagnostic possibilities for eye pain.
M—Malformations most certainly suggest glaucoma and all the refractive disorders (e.g.,
... READ EXCERPTS »
... Most textbooks consider the causes of red eye as conjunctivitis, iritis, or glaucoma, but it may be the result of taking the night plane from Los Angeles to New York. If these are all the causes you can remember you will be sadly mistaken in some cases. Most of the causes can be quickly
... READ EXCERPTS »
... Raccoon eyes are bilateral periorbital ecchymoses that don’t result from facial soft-tissue trauma. Usually an indicator of basilar skull fracture, this sign develops when damage at the time of fracture tears the meninges and causes the... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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...Negative oculocephalic reflex
An indicator of brain stem dysfunction, the absence of the doll's eye sign is detected by rapid, gentle turning of the patient's head from side to side. The eyes remain fixed in midposition, instead of the normal... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pictures
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...
Eye pain may be described as a burning, throbbing, aching, or stabbing sensation in or around the eye. It may also be characterized as a foreign-body sensation. This sign varies from mild to severe; its duration and exact location... Emergency interventions ... History and physical examination ... Pictures
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... Setting-sun sign refers to the downward deviation of an infant’s or a young child’s eyes as a result of pressure on cranial nerves III, IV, and VI. With this late and ominous sign of increased intracranial pressure (ICP), both eyes are rotated... History and physical examination ... Medical causes ... Special considerations ... Pictures
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... Inadequate dietary preparation for glucose tolerance test
Impaired glucose tolerance
Gestational diabetes
Type 1 diabetes (B-cell destruction, usually leading to
... READ EXCERPTS »
... Cerebral
Hypoxic encephalopathy
Oronasopharyngeal
Laceration
Fractured teeth
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... Superficial Cutaneous Infections
Molluscum contagiosum
HSV I and II
Cutaneous HPV
Condyloma
... READ EXCERPTS »
... Oral or Oropharynx
Infections
Candida spp.
HSV
CMV
EBV, oral hairy leukoplakia
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... Red Blood Cell Disorders
Etiologies of anemia
HIV infection
M. avium complex infection
Parvovirus B19 infection
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... Infections
Bacterial
Streptococcus pneumoniae
Salmonella spp.
Haemophilus influenzae
Staphylococcus aureus
... READ EXCERPTS »
... Retinitis
CMV
Toxoplasmosis
VZV
Fungal (especially C. neoformans and H. capsulatum)
... READ EXCERPTS »
... Infections
Pneumonia or pneumonitis
Bacterial
S. pneumoniae
H. influenzae
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... Pregnancy places special demands on carbohydrate metabolism and causes the insulin requirement to increase, even in a healthy female. Consequently, pregnancy may lead to a prediabetic state, to the conversion of an asymptomatic subclinical diabetic state to a clinical one ... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Vision, the most complex sense, has recently been the focus of some of the greatest medical and surgical innovations. Disorders that affect the eye generally lead to vision loss or impairment; routine ophthalmic examinations and early treatment can help prevent it. ... Review of anatomy ... Ocular layers ... The lens and accommodation ... Lacrimal apparatus and eyelids ... Depth perception ... Vision testing ... Subjective testing ... Pictures
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... An indicator of brain stem dysfunction, the absence of the doll’s eye sign is detected by rapid, gentle turning of the patient’s head from side to side. The eyes remain fixed in midposition, instead of the normal response of moving... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
... READ EXCERPTS »
... Eye pain may be described as a burning, throbbing, aching, or stabbing sensation in or around the eye. It may also be characterized as a foreign-body sensation. This sign varies from mild to severe; its duration and exact location provide clues to the... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Raccoon eyes are bilateral periorbital ecchymoses that don’t result from facial soft-tissue trauma. Usually an indicator of basilar skull fracture, this sign develops when damage at the time of fracture tears the meninges and causes the venous sinuses to bleed into the... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
... READ EXCERPTS »
... Usually associated with conjunctivitis, an eye discharge is the excretion of any substance other than tears. This common sign may occur in one or both eyes, producing scant to copious discharge. The discharge may be purulent, frothy, mucoid,... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Setting-sun sign refers to the downward deviation of an infant’s or young child’s eyes as a result of pressure on cranial nerves III, IV, and VI. With this late and ominous sign of increased intracranial pressure (ICP), both eyes are rotated downward, typically revealing an... History and physical examination ... Medical causes ... Special considerations ... Pictures
... READ EXCERPTS »
... John E. Sutherland
The most frequent causes of “red eye”—conjunctivitis, trauma, allergies, subconjunctival hemorrhage, and lid problems—are usually benign. Some conditions presenting with a red eye, however, require urgent... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment
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... Differential Overview
❑ Conjunctivitis
❑ Corneal abrasion
❑ Foreign body
❑ Sinusitis ... Diagnostic Approach ... Clinical Findings
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... Differential Overview
❑ Viral conjunctivitis
❑ Allergic conjunctivitis
❑ Bacterial conjunctivitis
❑ Corneal abrasion ... Diagnostic Approach ... Clinical Findings ... Pictures
... READ EXCERPTS »
... Pregnancy places special demands on carbohydrate metabolism and causes the insulin requirement to increase, even in a healthy woman. Consequently, pregnancy may lead to a prediabetic state, to the conversion of an asymptomatic subclinical diabetic state to a... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
... READ EXCERPTS »
... Eye pain may be described as a burning, throbbing, itching, aching, or stabbing sensation in or around the eye. It may also be characterized as a foreign-body sensation. This sign varies from mild to severe; its duration and exact location provide clues to the... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Usually associated with conjunctivitis, an eye discharge is the excretion of any substance other than tears. This common sign may occur in one or both eyes, producing scant to copious discharge. The discharge may be purulent, frothy, mucoid, cheesy, serous,... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Eye pain, or ophthalmalgia, may be described as a burning, throbbing, aching, or stabbing sensation in or around the eye. It may also be characterized as a foreign-body sensation. This sign varies from mild to severe; its duration and exact location provide clues to the causative disorder.... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
...Most cases of a red eye are due to relativelyminor infectious or allergic causes. Some cases, however, reflectmore serious eye pathology, which must be investigated further. Principal Causes of Red Eye Conjunctivitis Chemicals ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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... An indicator of brain stem dysfunction, the absence of the doll's eye sign is detected by rapid, gentle turning of the patient's head from side to side. The eyes remain fixed in midposition, instead of the normal response of moving laterally toward the side opposite the direction the head... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Eye pain may be described as a burning, throbbing, aching, or stabbing sensation in or around the eye. It may also be characterized as a foreign-body sensation. This sign varies from mild to severe; its duration and exact location provide clues to the causative disorder. ... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Raccoon eyes are bilateral periorbital ecchymoses that don't result from facial soft-tissue trauma. Usually an indicator of basilar skull fracture, this sign develops when damage at the time of a fracture tears the meninges and causes the venous sinuses to... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Usually associated with conjunctivitis, eye discharge is the excretion of a substance other than tears. This common sign may occur in one or both eyes, producing scant to copious discharge. The discharge may be purulent, frothy, mucoid, cheesy, serous, or clear or a stringy white... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Setting-sun sign refers to the downward deviation of an infant's or a young child's eyes as a result of pressure on cranial nerves III, IV, and VI. With this late and ominous sign of increased intracranial pressure (ICP), both eyes are rotated... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
...
The finding of glycosuria should prompt one to consider first the
conditions that are associated with faulty regulation of the blood
sugar and sugar metabolism. First and foremost on that list is diabetes
mellitus.... Pictures
... READ EXCERPTS »
...
To form a list of diagnostic possibilities in a case of hyperglycemia,
one needs only to think of the endocrine glands. Considering the pancreas
should prompt the recall of diabetes mellitus and glucagonomas. Considering
the adrenal gland... Pictures
... READ EXCERPTS »
...
Applying the mnemonic MINT to the various anatomic parts of the
eye will aid in systematically developing a list of diagnostic possibilities
for eye pain.
M—Malformations most certainly suggest glaucoma and all the
refractive disorders (e.g.... Pictures
... READ EXCERPTS »
...
Most textbooks consider the causes of red eye to be conjunctivitis,
iritis, or glaucoma, but it may be the result of taking the night plane from
Los Angeles to New York. If these are all the causes you can remember, you
will be sadly mistaken in some... Pictures
... READ EXCERPTS »
... Author:
Mindy Dickerman, MD
What to Do - Interpret the Data, Take Action
Obtaining digoxin levels in specific circumstances can be lifesaving.
Digoxin is the most widely used cardiac glycoside. These agents
inhibit the... Suggested Readings
... READ EXCERPTS »
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