Hypertension Meds Causing Cough

About 5% to 10% of patients taking an angiotensin converting enzyme inhibitor (ACE-I) for high blood pressure get a cough.  It usually occurs in the first 1-2 weeks of treatment, but may be delayed up to 6 months.  The cough is mild, without phlegm, and harmless, but continues so persistently that you’d go nuts continuingContinue reading “Hypertension Meds Causing Cough”

Tracheitis (“Croup” in children <3)

When the trachea gets infected, it’s almost always due to a virus.ย  Patients have a barking cough, no runny nose, and normal lung exam by stethoscope.ย  In children under 3, we call it croup; they can get significantly short of breath, because the trachea is narrow (see Diagram — Upper Respiratory Tract).ย  In older persons,Continue reading “Tracheitis (“Croup” in children <3)”


1.  Define “Fatigue” — Distinguish from other symptoms, esp. true “weakness”: “Weakness” = Neurologic diseases, rare but possibly very serious.  Patient may fall, or drop things. Identified by finding actual muscle weakness when testing patient’s strength “Fatigue” = feeling worn out, but muscle strength is normal when tested Shortness of Breath = Heart or LungContinue reading “Fatigue”


FIRST:  We determine if the “dizziness” is Vertigo or Lightheadedness Vertigo — room or person spinning or being thrust, in just one direction Lightheadednessย  —ย  a vague sense of being woozy, wobbly, unsteady, fuzzy, tipsy, etc., in any or all directionsSelect the specific type of “dizziness,” because the causes of each are completely different. VertigoContinue reading “Dizziness”

Acute Cough — Full Text

 โ€œAcute Coughโ€ means one going on 2-3 weeks.  This arbitrary definition is because the vast majority of cases are due to simple viral infections, which get better on their own in that time frame.  Therefore, we don’t order lots of tests, until viruses are no longer a consideration. So we won’t consider a lot ofContinue reading “Acute Cough — Full Text”

The Diagnosis Process

Clinicians shouldn’t aim to nail an immediate diagnosis. Instead, we create a mental list of common possibilities, called the โ€œDifferential Diagnosis.โ€  Then we systematically rule them out, especially deadly ones, while searching for a most-likely cause. We have lots of short-cuts. Often by clarifying a time-frame, we can rule out conditions that don’t fit. ForContinue reading “The Diagnosis Process”

Vaginal Bleeding

NOTE:  This topic addresses bleeding from the Uterus.  It may be called โ€œVaginal,โ€ since it comes out the vagina, but thatโ€™s not where it originates (see Diagram — Female Genital System). A pelvic exam can easily tell if bleeding is truly vaginal. FIRST STEPย  —ย  Pregnancy Test (for virtually everyone; see link) Since all womenContinue reading “Vaginal Bleeding”

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