Carolinas Core Concepts Core Concepts in EM; a repository for Carolinas lecture summaries.

10Nov/111

M&M

Angela Fusaro, M.D.

  • A normal WBC (less than 10), a normal diff (neutrophils less than 75%) and a normal CRP (less than 1) have a NPV of 84% for appendicitis. If all three are elevated (in a patient who you suspect could have appendicitis), there is a sensitivity of 97%.
  • The most common symptoms of a posterior circulation stroke are non-specific (nausea, vomiting, headache, 'dizziness').
  • CT scans are not sensitive for posterior circulation strokes, especially early on in the disease process.
  • Checking for nystagmus, ocular alignment and vestibulocular reflexes can help identify an abnormality, and determine if it peripheral or central.
  • Nystagmus that is horizontal, resolves when you focus on an object, and is uni-directional is BENIGN. Any other nystagmus suggests badness.
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  1. Core Concepts Team
    November 21st, 2011 - 14:23

    Doubt #1 is accurate. Do you have the reference? CRP performs better than that for NPV

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2749345/

    Academically still engaged,
    PB

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