Memory Loss — Unethical Anecdote

A 30-year-old Spanish-speaking woman complained of forgetting things.  She was a single mom working 2 jobs, and we counted out that she never slept over 4 hours a night.  Diagnosis made (in a few-minute visit) — Sleep Deprivation as cause of memory loss.  Then she explainedโ€ฆ A radio announcement “do you or your loved onesContinue reading “Memory Loss — Unethical Anecdote”

Memory Loss — Missed Diagnosis

An 87-year-old Mexican man, with advanced dementia who was sometimes combative (threw forks at home), diagnosed with Alzheimer’s Disease for over 20 years, was brought in by his son as a new patient.  Apparently other family out-of-state got worn out, arrived unannounced to hand him off, and promptly fled.  Medical records were impossible to comeContinue reading “Memory Loss — Missed Diagnosis”

Memory Questionnaire

This is intended to be used with family or friends of a patient who is being evaluated for memory loss. It’s a brief, eight-item questionnaire (“AD8”) which has been studied and appears to help detect dementia. Informants are asked whether the patient has exhibited any increase in the following deficits or behaviors (not just occurringContinue reading “Memory Questionnaire”


Delirium is defined as acute Confusion, with some degree of Agitation.ย  It’s always a medical (or psychiatric) emergency.ย  There are countless causes, which must be diagnosed by lab tests & images (x-rays, etc.) in an E.R.ย  For example, patients with acute psychotic breakdown, drug overdose on stimulants (cocaine, speed) or hallucinogens (LSD, PCP), and severeContinue reading “Delirium”

Nausea / Vomiting — Full Text

This is one of the trickiest symptoms for us clinicians to deal with.  Whereas prominent diarrhea invariably comes from the bowel, nausea / vomiting can be caused by conditions anywhere in the body.  For example, try this for a smattering of possibilities (in random order): Simple stomach infection Brain Infections / Increased Intracranial Pressure (lethal)Continue reading “Nausea / Vomiting — Full Text”

Vaginal Discharge — Full Text

Vaginal discharge can be normal for women, and can change throughout the menstrual cycle.  But if becomes worse than ever before, turns an unusual dark color, or begins to itch or hurt, then it’s certainly not normal.  So we call it “Vaginitis,” usually meaning infection (sometimes just inflammation) of the vagina. Vaginitis may be dueContinue reading “Vaginal Discharge — Full Text”

Vaginal Discharge

Vaginal discharges are annoying and uncomfortable, but rarely if ever dangerous. Some itch, others don’t. Clinicians often simply diagnose “Yeast” if there’s itching, which is quick and avoids the need for a pelvic exam, but risks missing some important conditions. The following approach recommends collecting appropriate specimens, described in more detail in our Full Text.Continue reading “Vaginal Discharge”

Lightheadedness — Full Text

This is a tough symptom.  We won’t discuss it much, because “Lightheadedness” is so vague, it could mean almost anything.  The most common cause is Anxiety, but it could also be something like stroke, sepsis, lung disease (low oxygen), heart disease, pregnancy, diabetes, metabolic derangements (low potassium, high calcium, etc. etc.), etc. etc. If theContinue reading “Lightheadedness — Full Text”

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