...
Is there associated hyperphagia? If the patient recognizes that he or she has a ravenous appetite or eats more than is necessary, the possibility of an insulinoma or Fröhlich's syndrome should be considered.
Is the obesity ... DIAGNOSTIC WORKUP
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...
Is it reducible? If the mass is reducible, it is most likely a femoral hernia or saphenous varix.
Is there an associated kyphotic curvature of the spine? The findings of a kyphotic curvature of the spine suggest a psoas abscess ... DIAGNOSTIC WORKUP
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...
Is it painful? A painful rectal mass should suggest perirectal abscess, thrombosed hemorrhoid, anal ulcer, ruptured ectopic pregnancy, tubo-ovarian abscess, and pelvic appendix.
Is it soft or cystic? The presence of a soft ... DIAGNOSTIC WORKUP
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...
Any mass in the anal canal or rectum should be considered cancer until ruled out. Colorectal cancer must be considered, as it is the second leading cause of cancer death in the U.S., with greater than 40,000 mortalities each year. Early detection and aggressive... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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...
Scrotal masses and swelling can involve the contents of the scrotum, the wall of the scrotum, and the scrotum itself. Ultrasonography should be used liberally in evaluating scrotal masses. All solid masses must be evaluated by surgical exploration.... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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...
Pediatric obesity is increasing at epidemic proportions. The Centers for Disease Control define “at risk of overweight” as a body mass index (BMI, kg/m2) of ≥85%ile and <95%ile for age and sex, and “overweight>... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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... The differential diagnosis of obesity, like that of weight loss, is best developed using physiology because most cases of obesity are caused by an absolute increased intake of calories or a relative increased intake of calories over output of energy. Fluid
... READ EXCERPTS »
... Aside from the common external hemorrhoids (which will not be seen in many cases unless the patient is asked to bear down), anal masses may include any of the following:
Skin tag from previous ruptured or incised hemorrhoids
Sentinel
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... It is not uncommon for a patient to complain of a lump on his or her back. Most of the time the lesion is a sebaceous cyst or lipoma. However, there are other types of back masses, and a simple method of recall is needed. Anatomy is the key. If the mnemonic MINT
... READ EXCERPTS »
... In developing the differential diagnosis of an epigastric mass, one merely needs to visualize the anatomy of the epigastrium from skin to spine. The conditions are presented in outline form in Table 5 , but the important conditions are emphasized in the
... READ EXCERPTS »
... When the clinician tries to recall the causes of a mass in the extremities, he or she should consider the anatomy. As the clinician dissects downward from the skin, he or she encounters the subcutaneous tissue, veins, muscles, ligaments, bursae, arteries, lymph nodes, nerves, bones, and
... READ EXCERPTS »
... More physicians have been fooled by a hypogastric mass than by a mass in any other area. How many times can you recall the mass disappearing on the operating table after catheterization of the bladder? More often than not, the mass is more apparent than real because
... READ EXCERPTS »
... Because most orbital masses cause exophthalmos, the differential diagnosis of the two is very similar (for illustration see section on exophthalmos, page 193). The best method to use to arrive at the causes is to visualize the anatomy of the orbit and then to think of the mnemonic MINT.
... READ EXCERPTS »
... When the clinician lays his or her hand on the right upper quadrant (RUQ) and feels a mass, he or she should visualize the anatomy and the differential diagnosis should become clear. Proceeding from the skin, the physician encounters the subcutaneous tissue,
... READ EXCERPTS »
... To quickly develop a list of etiologies of a left lower quadrant (LLQ) mass, visualize the anatomy of the area. Compared to the RUQ, the number of organs there is few. Beneath the skin, subcutaneous tissue, fascia, and muscle are the sigmoid colon, the
... READ EXCERPTS »
... The differential diagnosis for left upper quadrant (LUQ) masses is not a great deal different from that of the RUQ. The anatomy is similar: just replace the liver with the spleen and the gallbladder with the stomach. The presence of the aorta on the
... READ EXCERPTS »
... Although anatomy may assist somewhat in developing the differential here, it is probably an unnecessary exercise because the mnemonic MINT will bring to mind virtually all the etiologies.
M—Malformation reminds one of the
... READ EXCERPTS »
... Anatomy is once again the key to developing a differential diagnosis of a right lower quadrant (RLQ) mass. Underneath the skin, subcutaneous tissue, fascia, and muscle, lie the cecum, appendix, terminal ileum, iliac artery and vein, and ileum.
... READ EXCERPTS »
... The differential diagnosis of this symptom and sign is similar to that of chest pain: Anatomy is the key to both. After visualizing all the organs of the chest and cross-indexing them with the mnemonic MINT, a convenient and extensive
... READ EXCERPTS »
... Of course, the physician is looking for a rectal carcinoma when performing a routine rectal examination, but what else might be found? Use the mnemonic VINDICATE to have a list of possibilities clearly in mind before the examination.
V—Vascular suggests internal
... READ EXCERPTS »
... Abdominal distention refers to increased abdominal girth — the result of increased intra-abdominal pressure forcing the abdominal wall outward. Distention may be mild or severe, depending on the amount of pressure. It may be localized or diffuse and may occur gradually or... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations
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... Mechanical Bowel Obstruction
Extraluminal compression
Congenital abnormalities
Annular pancreas
... READ EXCERPTS »
... Anterior
Substernal thyroid
Thymoma
Lymphoma
Germinal cell neoplasm (e.g., dermoid)
Ascending aortic aneurysm
Parathyroid
... READ EXCERPTS »
... Obesity is an excess of body fat, generally 20% above ideal body weight. The prognosis for correction of obesity is poor: Fewer than 30% of patients succeed in losing 20 lb (9 kg), and only half of these maintain the loss over a prolonged period. ... Causes and incidence ... Diagnosis ... Treatment ... Special considerations
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... Abdominal distention refers to increased abdominal girth—the result of increased intra-abdominal pressure forcing the abdominal wall outward. Distention may be mild or severe, depending on the amount of pressure. It may be localized or diffuse... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Pepi Granat
Although most mediastinal masses are discovered incidentally on chest radiographs, symptoms can sometimes provide clues enabling the timely ordering of these films. The mediastinum is defined as the extrapleural space within the thorax lying... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment
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... Robert L. Hatch
Scrotal masses are common, occurring in all age groups, from infants to elderly men. In fact, up to 20% of adult males have varicocele (1). Many scrotal masses are benign and require no treatment, whereas others require... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment
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... Differential Overview
❑ Caloric excess
❑ Depression
❑ Drugs
❑ Hypothyroidism
❑ ... Diagnostic Approach ... Clinical Findings ... Pictures
... READ EXCERPTS »
... Abdominal distention refers to increased abdominal girth — the result of increased intra-abdominal pressure forcing the abdominal wall outward. Distention may be mild or severe, depending on the amount of pressure. It may be localized or diffuse and may occur gradually or suddenly... Emergency Actions ... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Obesitycan be defined as an excess of body fat. Children with obesity are at risk fordevelopment of diabetes mellitus, hypertension, sleep apnea, anddyslipidemia. They also may lack confidence and self-esteem andcan develop significant depression. There are no... Principal Causes of Obesity ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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... Abdominal distention refers to increased abdominal girth—the result of increased intra-abdominal pressure forcing the abdominal wall outward. Distention may be mild or severe, depending on the amount of pressure. It may be localized or... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
...
Aside from the common external hemorrhoids (which will not be seen in
many cases unless the patient is asked to bear down), anal masses may
include any of the following:
Skin tag ... Pictures
... READ EXCERPTS »
...
It is not uncommon for a patient to complain of a lump on his or her
back. Most of the time, the lesion is a sebaceous cyst or lipoma. However,
there are other types of back masses, and a simple method of recall is
needed. Anatomy is the... Pictures
... READ EXCERPTS »
...
When the clinician tries to recall the causes of a mass in the
extremities, he or she should consider the anatomy. As the clinician
dissects downward from the skin, he or she encounters the subcutaneous
tissue, veins, muscles, ligaments, bursae,... Pictures
... READ EXCERPTS »
...
To develop a list of possible causes of a face mass, let’s turn to
anatomy. The face is composed of skin, subcutaneous tissues, muscle, bone,
teeth, the sinuses, salivary glands, arteries, veins, and nerves. Applying the mnemonic VINDICATE
... READ EXCERPTS »
...
The differential diagnosis of obesity, like that of weight loss, is
best developed using physiology because most cases of obesity are
caused by an absolute increased intake of calories or a relative increased
intake of... Pictures
... READ EXCERPTS »
...
Because most orbital masses cause exophthalmos, the differential
diagnosis of the two is very similar (for illustration, see section on
exophthalmos, page 158). The best
method to use to arrive at the causes is to visualize the anatomy
of
... READ EXCERPTS »
...
Simply by thinking of the location of the pulsatile mass, one can
identify the cause or causes of a pulsatile mass.
Orbit. This is most likely an arteriovenous fistula related to
trauma or the spontaneous rupture of an aneurysm into the cavernous sinus.
... READ EXCERPTS »
...
In developing the differential diagnosis of an epigastric mass, one
merely needs to visualize the anatomy of the epigastrium from skin to spine.
The conditions are presented in outline form in Table 5, but the
important conditions are emphasized in the following... Pictures
... READ EXCERPTS »
...
More physicians have been fooled by a hypogastric mass than by a mass
in any other area. How many times can you recall the mass disappearing on
the operating table after catheterization of the bladder? More often than
not, the mass is more... Pictures
... READ EXCERPTS »
...
The differential diagnosis of this symptom and sign is similar to that
of chest pain: Anatomy is the key to both. After visualizing all the
organs of the chest and cross-indexing them with the mnemonic MINT, a
convenient and... Pictures
... READ EXCERPTS »
...
When the clinician lays his or her hand on the RUQ and feels a mass, he
or she should visualize the anatomy and the differential diagnosis should
become clear. Proceeding from the skin, the physician encounters the
subcutaneous tissue, fascia, muscle, peritoneum,... Pictures
... READ EXCERPTS »
...
Although anatomy may assist somewhat in developing the differential
here, it is probably an unnecessary exercise because the mnemonic
MINT will bring to mind virtually all the etiologies.
M—Malformation reminds one of the broad nose of cretinism
... READ EXCERPTS »
...
To quickly develop a list of etiologies of a left lower quadrant (LLQ)
mass, visualize the anatomy of the area. Compared to the RUQ, the
number of organs there is few. Beneath the skin, subcutaneous tissue,
fascia, and muscle are the sigmoid colon, the iliac... Pictures
... READ EXCERPTS »
...
The differential diagnosis for left upper quadrant (LUQ) masses is not
a great deal different from that of the RUQ. The anatomy is similar: Just
replace the liver with the spleen and the gallbladder with the stomach. The
presence... Pictures
... READ EXCERPTS »
...
Of course, the physician is looking for a rectal carcinoma when
performing a routine rectal examination, but what else might be found? Use
the mnemonic VINDICATE to have a list of possibilities clearly in
mind before the examination.
V&... Pictures
... READ EXCERPTS »
... Charles Bailey, MD, PhDDon E. Eslin, MD, PhD (4th Edition) Mediastinal Mass - BASICS Mediastinal Mass - description Space-occupying lesion of the mediastinum: Anterior ... Mediastinal Mass - DIAGNOSIS ... Mediastinal Mass - TREATMENT ... Mediastinal Mass - FOLLOW UP ... Mediastinal Mass - bibliography ... Mediastinal Mass - CODES ... Mediastinal Mass - FAQ
... READ EXCERPTS »
... Sandra Gibson Hassink, MD
George A. Datto III, MD
Obesity - BASICS
Obesity - description
A chronic disease defined as having an excess of body fat. Body mass index (BMI), which is defined as weight... Obesity - DIAGNOSIS ... Obesity - TREATMENT ... Obesity - FOLLOW UP ... Obesity - bibliography ... Obesity - CODES ... Obesity - FAQ
... READ EXCERPTS »
For the 8 million Americans considered morbidly obese, health problems are virtually inevitable. But new procedures are helping people take the...
Many obese people are turning to stomach surgery to help them get on the road to a healthier life. Learn about the different procedures doctors are...
Think watching your weight is just a cosmetic concern? Think again. Gaining too much weight can lead to serious health risks, and an estimated...
Kids across the country eat too much and exercise too little. Doctors say that's a formula for weight problems, obesity and future health...