Image source: AllergyCases.org
An example of an abnormal nasopharyngoscopy image is shown below with a slightly edematous epiglottis, normal vocal cords, and normal arytenoid cartilage.
This installment of the Paucis Verbis (In a Few Words) e-card series reviews Angioedema.
The 1999 study on admission guidelines, of course, should be weighed with physician judgment and the patient's social issues. The study was retrospective and the results should be weighed carefully. For me, generally I admit all intraoral angioedema cases and progressively worsening extraoral angioedema. I also perform fiberoptic nasopharyngoscopy on all patients with voice changes.
The 1999 study on admission guidelines, of course, should be weighed with physician judgment and the patient's social issues. The study was retrospective and the results should be weighed carefully. For me, generally I admit all intraoral angioedema cases and progressively worsening extraoral angioedema. I also perform fiberoptic nasopharyngoscopy on all patients with voice changes.
Feel free to download this card and print on a 4'' x 6'' index card.
Great post...although I find that it takes a few days for that lip to start looking a little more normal again, despite high dose steroids and antihistamines. What is your experience? Great post and pics...
ReplyDeleteQuestion - for the treatment you have H2 blockers, to my knowledge those primarily block H2 receptors on parietal cells in the stomach to decrease acid secretion. Didn't realize they can also help with Angioedema.
ReplyDeleteBTW - These are great and I look forward to carrying them with me.
Anar: There is some thought that H2 blockers have some competitive H1 blocking ability to enhance the ability of antihistamines. So we give a benadryl/pepcid combo here. Glad that these cards help. They actually force me to read something every week, which I've been bad about ever since residency.
ReplyDeleteStorytellERdoc: Yes, it takes the lip quite a while to return to normal. Once on the path of recovery though, it usually doesn't rebound back fortunately. The pictures are from online photos that I found. There were some scarier ones, but I didn't want to go overboard.
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