Shauna Hsiao

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Acute cholangitis is caused primarily by bacterial infection in a patient with biliary obstruction.
Acute cholangitis: Clinical manifestations, diagnosis, and management - UpToDate
It commonly presents with hematemesis (vomiting of blood or coffee ground-like material) and/or melena (black, tarry stools).
Causes of upper gastrointestinal bleeding in adults - UpToDate
The classification is based on radiographic characteristics of the tumor host margin.
In Brief: Classifications in Brief: Enneking Classification: Benign and Malignant Tumors of the Musculoskeletal System - PMC
latent, active, and aggressive
In Brief: Classifications in Brief: Enneking Classification: Benign and Malignant Tumors of the Musculoskeletal System - PMC
Historically, surgical resection has been the cornerstone for management of musculoskeletal sarcomas. Thus the most useful staging system would guide the nature of the surgical procedure.
In Brief: Classifications in Brief: Enneking Classification: Benign and Malignant Tumors of the Musculoskeletal System - PMC
Kellgren and Lawrence OA severity grading system
Clinical manifestations and diagnosis of osteoarthritis - UpToDate
Hypovolemic shock encompasses disease processes that reduce CO (and oxygen delivery) via a reduction in preload.
Approach to the Patient with Shock | Harrison's Principles of Internal Medicine, 21e | AccessMedicine | McGraw Hill Medical
but in this case the etiology of the reduced CO is an extracardiac pulmonary vascular or mechanical process impairing blood flow.
Approach to the Patient with Shock | Harrison's Principles of Internal Medicine, 21e | AccessMedicine | McGraw Hill Medical
Cardiogenic shock is characterized by reduced oxygen delivery related to a reduction in CO owing to a primary cardiac problem.
Approach to the Patient with Shock | Harrison's Principles of Internal Medicine, 21e | AccessMedicine | McGraw Hill Medical
there is evidence of both venous and arterial vasodilation.
Approach to the Patient with Shock | Harrison's Principles of Internal Medicine, 21e | AccessMedicine | McGraw Hill Medical
there is a profound distributive type of shock possibly mediated through histamine release.
Approach to the Patient with Shock | Harrison's Principles of Internal Medicine, 21e | AccessMedicine | McGraw Hill Medical
In older adults, infection, cardiovascular disease, and dehydration must particularly be considered as possible causes of weakness.
Evaluation of the adult with acute weakness in the emergency department - UpToDate
Arterial lactate is a long-studied marker of tissue hypoperfusion, and hyperlactemia and delayed lactate clearance are associated with a greater incidence of organ failure and death in sepsis.
Sepsis and Septic Shock | Harrison's Principles of Internal Medicine, 21e | AccessMedicine | McGraw Hill Medical
With ≥2 new SOFA points, the infected patient is considered septic and may be at ≥10% risk of in-hospital death.
Sepsis and Septic Shock | Harrison's Principles of Internal Medicine, 21e | AccessMedicine | McGraw Hill Medical
There is no specific test for sepsis, nor is there a gold-standard method for determining whether a patient is septic. In fact, the definition of sepsis can be written as a logic statement: sepsis = f (threat to life | organ dysfunction | dysregulated host response | infection),
Sepsis and Septic Shock | Harrison's Principles of Internal Medicine, 21e | AccessMedicine | McGraw Hill Medical
In addition, whatever the initial cause of kidney disease, a sustained decrease in GFR can produce adaptive hyperfiltration within the remaining functional nephrons, which may lead to further injury and worsening of CKD.
Chronic kidney disease (newly identified): Clinical presentation and diagnostic approach in adults - UpToDate
a patient with severe heart failure may have recurrent or prolonged acute kidney injury (AKI) due to reduced effective arterial blood volume (ie, prerenal disease). Over time, even if cardiac function and renal perfusion pressure improve, glomerular filtration rate (GFR) may never fully recover to normal.
Chronic kidney disease (newly identified): Clinical presentation and diagnostic approach in adults - UpToDate
The causes of kidney injury are classically divided into three categories: prerenal; intrinsic renal; or postrenal. However, any cause of kidney injury, if sufficiently severe or long-standing, may lead to persistently abnormal kidney function and therefore CKD.
Chronic kidney disease (newly identified): Clinical presentation and diagnostic approach in adults - UpToDate
Symptoms should improve promptly if antimicrobial therapy is effective.
Acute complicated urinary tract infection (including pyelonephritis) in adults - UpToDate
Empiric antimicrobial therapy should be initiated promptly, taking into account risk factors for drug resistance, including previous antimicrobial use and results of recent urine cultures, with subsequent adjustment guided by antimicrobial susceptibility data.
Acute complicated urinary tract infection (including pyelonephritis) in adults - UpToDate
The presence of bacteriuria (≥105 colony-forming units/mL of a uropathogen) with or without pyuria in the absence of any symptom that could be attributable to a UTI is called asymptomatic bacteriuria and generally does not warrant treatment in nonpregnant patients who are not undergoing urologic surgery.
Acute complicated urinary tract infection (including pyelonephritis) in adults - UpToDate
Fever or sepsis without localizing symptoms in the setting of pyuria and bacteriuria may be attributed to UTI if other causes have been ruled out.
Acute complicated urinary tract infection (including pyelonephritis) in adults - UpToDate
CT findings of pyelonephritis include localized hypodense lesions due to ischemia induced by marked neutrophilic infiltration and edema (image 1A-C) [20,22]. The CT can be normal in patients with mild infection
Acute complicated urinary tract infection (including pyelonephritis) in adults - UpToDate
Contrast is needed to demonstrate alterations in renal perfusion
Acute complicated urinary tract infection (including pyelonephritis) in adults - UpToDate
Computed tomography (CT) scanning of the abdomen and pelvis (with and without contrast) is generally the study of choice to detect anatomic or physiologic factors associated with acute complicated UTI
Acute complicated urinary tract infection (including pyelonephritis) in adults - UpToDate
Pyuria is present in almost all patients with UTI.
Acute complicated urinary tract infection (including pyelonephritis) in adults - UpToDate
Individuals who do not fit into either category have often been treated as having a complicated UTI by default.
Acute complicated urinary tract infection (including pyelonephritis) in adults - UpToDate
We also do not automatically consider men to have acute complicated UTI in the absence of concerning symptoms for upper tract or systemic infection.
Acute complicated urinary tract infection (including pyelonephritis) in adults - UpToDate
We do not automatically consider patients with underlying urologic abnormalities
Acute complicated urinary tract infection (including pyelonephritis) in adults - UpToDate
By this definition, pyelonephritis is a complicated UTI, regardless of patient characteristics.
Acute complicated urinary tract infection (including pyelonephritis) in adults - UpToDate
Urinary tract infections (UTIs) include cystitis (infection of the bladder/lower urinary tract) and pyelonephritis (infection of the kidney/upper urinary tract).
Acute simple cystitis in females - UpToDate
Acute complicated urinary tract infection (UTI) should be suspected in patients with dysuria, urinary frequency or urgency, or suprapubic pain who also have fever, chills, flank pain, pelvic or perineal pain (in men), or who otherwise appear clinically ill.
Acute complicated urinary tract infection (including pyelonephritis) in adults - UpToDate
Patients with acute complicated UTI also have fever or other features of systemic illness (including chills, rigors, or marked fatigue or malaise beyond baseline), which suggest that infection has extended beyond the bladder.
Acute complicated urinary tract infection (including pyelonephritis) in adults - UpToDate
Symptoms and signs of cystitis include dysuria, urinary frequency and urgency, suprapubic pain, and hematuria.
Acute complicated urinary tract infection (including pyelonephritis) in adults - UpToDate
when there are symptoms of cystitis in the absence of fever, flank pain, costovertebral angle tenderness, and other signs of systemic illness, we consider this acute simple cystitis.
Acute complicated urinary tract infection (including pyelonephritis) in adults - UpToDate
Urinary tract infections (UTIs) include cystitis (infection of the bladder/lower urinary tract) and pyelonephritis (infection of the kidney/upper urinary tract).
Acute complicated urinary tract infection (including pyelonephritis) in adults - UpToDate
it can be difficult on clinical grounds to distinguish cystitis from pyelonephritis
Urinary tract infections in infants older than one month and children less than two years: Acute management, imaging, and prognosis - UpToDate
Acute decompensated heart failure (ADHF) is a clinical syndrome of new or worsening signs and symptoms of HF that often lead to hospitalization or an emergency department visit.
Approach to diagnosis and evaluation of acute decompensated heart failure in adults - UpToDate
Neurologic pain is predominantly due to neurospinal (eg, disc disease, spinal stenosis, tumor) or neuropathic causes (eg, diabetes, alcohol abuse).
Clinical features and diagnosis of lower extremity peripheral artery disease - UpToDate
Vascular imaging is not generally necessary for establishing a diagnosis of PAD
Clinical features and diagnosis of lower extremity peripheral artery disease - UpToDate
The ABI is the ratio of the ankle systolic blood pressure divided by the brachial systolic pressure detected with a Doppler probe.
Clinical features and diagnosis of lower extremity peripheral artery disease - UpToDate
Most symptomatic patients with PAD present with lower extremity pain, either as classic intermittent claudication or atypical leg pain.
Clinical features and diagnosis of lower extremity peripheral artery disease - UpToDate
Acute inflammation generally shows a marked CRP response while low-grade inflammation shows only minor CRP elevation.
Acute phase reactants - UpToDate
This poorly defined state, sometimes referred to as mini-inflammation or subclinical inflammation, occurs in many conditions in which there are minor degrees of metabolic dysfunction, such as obesity and insulin resistance
Acute phase reactants - UpToDate
Minor CRP elevation (concentrations between 3 and 10 mg/L)
Acute phase reactants - UpToDate
We have learned that the innate immune system responds to metabolic stress with chronic low-grade inflammation ("metaflammation") without the classic signs of acute inflammation.
Acute phase reactants - UpToDate
The skin envelope is the overlying skin and subcutaneous fat of the breast
Surgical and anatomical details of the breast | beautiful A.B.C.
The conus refers to the three dimensional shape, projection and volume of the breast.
Surgical and anatomical details of the breast | beautiful A.B.C.
The footprint is the outline of the breast base on the chest wall and is the interface of the posterior surface of the breast with the thoracic cavity.
Surgical and anatomical details of the breast | beautiful A.B.C.
The revision for the proposed 8th edition compared to the 7th edition of AJCC TNM staging system consisted of changes in the T descriptors that reclassifies tumor size into the more refined T subgroups,
Comparison of the 7th and proposed 8th editions of the AJCC/UICC TNM staging system for non-small cell lung cancer undergoing radical surgery | Scientific Reports