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In a departure from the structure of previous editions of this encyclopedia, the 15th edition of Meyler ' s Side Effects of Drugs was organized as individual drug monographs in alphabetical order. This method has been continued in this edition, the 16th. In many cases a general monograph (e.g. antihistamines) is complemented by monographs about specific drugs (e.g. acrivastine, antazoline, etc.); in that case a cross-reference…

Ventilation-Perfusion Scan

Background A pulmonary ventilation-perfusion scan (V/Q scan) is a nuclear medicine scan that uses radioactive material to examine air flow (ventilation) and blood flow (perfusion) through the lungs. In respiratory physiology, Q is the letter to describe blood flow, hence the name V/Q scan. The V/Q scan may also be referred to as lung scintigraphy since a gamma camera is used to acquire images. You’re Reading…

Urinary Catheters

Background Urinary catheters are used in the inpatient and outpatient settings to assist in draining the bladder of urine. Indwelling catheters are placed in about 25% of hospitalized patients during their hospital stay. Indwelling catheters (commonly called “Foley catheters”) have been in use since the 1930s. The origin of the word “catheter” comes from ancient Greek word kathiénai , meaning “to thrust into” or “to send…

Urinalysis

Background The concept that ordinary bodily fluids could yield insight into physiology emerged from the examination of urine. In fact, laboratory medicine began 6,000 years ago when Sumerian and Babylonian physicians recorded onto clay tablets their reflections on urine, thus introducing the objective study of human urine (a feat that would be called uroscopy , now called urinalysis [UA]). UA is a simple, cheap, noninvasive test…

Transjugular Intrahepatic Portosystemic Shunt

Background Transjugular intrahepatic portosystemic shunt (TIPS), introduced in the 1980s, is a procedure that is performed with imaging to connect the portal vein to the hepatic vein through the liver. Sequelae of advanced liver disease and cirrhosis include portal hypertension, which is defined by increased pressure in the portal circulation due to high resistance to blood flow through the cirrhotic liver; a TIPS will decrease this…

Transcatheter Aortic Valve Replacement

Background The most common valvular disease of the heart in adults is aortic stenosis (AS) with a noted increased incidence with aging. , Patients typically experience a slow decline in the aortic valve area over many years. The tipping point is the development of symptoms, after which there is increased mortality if the AS is left untreated. , Patients may experience shortness of breath, chest discomfort,…

Thyroid Uptake and Scan

Background Radioactive iodine (RAI) uptake and scan is a direct, noninvasive test used to assess the function of the thyroid gland. RAI uptake and scan is frequently interchangeable with “RAI scan” or “RAI uptake” in clinical practice. However, the RAI test involves two separate phases including the uptake and the scan. Thus, to be clear, RAI uptake and scan will be the term used in this…

Thyroid Ablation

Background Thyroid ablation is a procedure where the thyroid tissue is destroyed via radioactive iodine (RAI), percutaneous ethanol injection, radiofrequency, or laser ablation. The most common form of thyroid ablation used in the United States is RAI, in the form of 131 I. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member.…

Stress Tests

Background Cardiac stress tests are common procedures that are performed to evaluate patients for evidence of coronary artery disease (CAD). The gold standard for the diagnosis of CAD is cardiac catheterization and angiography; however, this is an invasive procedure that is not indicated for all patients. Therefore, many patients with a low to intermediate risk for CAD will undergo stress testing first to ascertain whether a…

Speech-Language and Swallow Evaluations

Background As a whole, speech-language pathology assessments are conducted for the examination of speech, language, cognitive abilities, and swallowing safety and function. Within the medical setting, there are a number of types of evaluations performed by speech-language pathologists (SLPs) that provide valuable information to guide medical management of patients. These assessments include clinical swallowing evaluations and instrumental swallowing exams such as modified barium swallow (MBS) study…

Sleep Study

Backgound There are multiple diagnostic tests to evaluate sleep disorders. Common tests include polysomnograph (PSG), home sleep apnea test (HSAT), multiple sleep latency test (MSLT), oximetry, and actigraphy. PSG, also known as an “in-lab sleep study or sleep test,” is derived from the Greek roots “poly,” meaning many, “somno,” meaning sleep, and “graphy,” meaning to write, and refers to testing performed on patients while they sleep.…

Renal Ultrasound

Background Renal ultrasound is a noninvasive diagnostic test that uses high-frequency sound waves to create real-time images of the kidneys. The images are two-dimensional pictures of the kidneys that evaluate their size, shape, architecture, and location. It can also be used to evaluate the blood flow to and from the kidneys. The underlying complex architecture of the kidneys is represented by the variety of echotextures seen…

Peritoneal Dialysis

Background Peritoneal dialysis (PD) is a modality of renal replacement therapy using a patient’s peritoneal cavity and extensive capillary vasculature as a dialysis membrane. The concept is exactly the same as hemodialysis (HD); both involve the transport of solutes and water across a membrane that separates two fluid-containing compartments. In HD the dialyzer is the membrane, whereas in PD the peritoneal lining is the membrane. This…