General Internal Medicine

Geriatric Medicine

Questions discussed in this category

For elderly patients (i.e. older than 80) with only one documented episode of paroxysmal atrial fibrillation following a stress event (such as acute illness/steroid administration) and a CHADsVASc score greater than 1, how would you counsel them on the risks/benefits of anticoagulation and subsequent monitoring for afib recurrence?

6 Answers available

How do you counsel patients who are concerned that discontinuation of certain chronic medications may actually perpetuate suffering at the end of life?

Do you ever continue medications such as rate-control agents for tachyarrhythmias, anticoagulation for blood clots, immunosuppression to prevent trans...

1 Answer available

Is there any benefit in maintaining statin or aspirin therapy in patients >75 years old with stable, multivessel ischemic heart disease in light of challenges encountered with polypharmacy?

2 Answers available

Does aspirin dose (81 mg vs 325 mg) matter for secondary stroke prevention?

Should some patients get 325 mg instead of 81mg at least for a certain amount of time, such as patients in the acute phase of ischemic stroke or patie...

1 Answer available

How would you approach the work up of SLE in a patient over 80 years old?

How would you work up an elderly female with persistent anemia secondary to warm AIHA requiring almost monthly transfusion, with positive ANA,dsDNA (b...

3 Answers available

What criteria are used to choose a specific dose of aspirin in ischemic stroke?

We have seen 81 vs 162 vs 325 mg up to 1300 mg.

3 Answers available

What duration of dual antiplatelet therapy do you use for secondary prevention of ischemic stroke due to intracranial atherosclerotic disease?

While some have the practice of 90 days per SAMMPRIS trial, the lower rates of ischemic stroke in the medical therapy group were driven by events with...

8 Answers available

Would you recommend PFO closure in patients >60 years old with presumed paradoxical embolism as their mechanism of stroke?

2 Answers available

How do you approach a mildly positive finding on an autoimmune encephalitis panel when there is no other evidence of encephalitis (such as elevated CSF protein, abnormal imaging, or EEG findings)?

For example, a GAD65 Ab of 0.07 when the cut-off is 0.02. Does this answer change if you consider adult vs pediatric populations?

2 Answers available

Papers discussed in this category

Neurology, 2015-09-29

Dual antiplatelet therapy in stroke and ICAS: Subgroup analysis of CHANCE.

Stroke, 2017-08

Challenges in the Medical Management of Symptomatic Intracranial Stenosis in an Urban Setting.

Stroke, 2021 May 24

2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association/American Stroke Association.

Lancet (London, England), 2014-01-25

Aggressive medical treatment with or without stenting in high-risk patients with intracranial artery stenosis (SAMMPRIS): the final results of a randomised trial.

Circulation, 2019-08-20

Time Course for Benefit and Risk of Clopidogrel and Aspirin After Acute Transient Ischemic Attack and Minor Ischemic Stroke.

Archives of neurology, 2009-06

Ganglionic acetylcholine receptor autoantibody: oncological, neurological, and serological accompaniments.

Muscle & nerve, 2013-04

Striational antibodies in a paraneoplastic context.

Muscle & nerve, 2016-08

P/Q- and N-type calcium-channel antibodies: Oncological, neurological, and serological accompaniments.

Muscle & nerve, 2017-07

GAD65 neurological autoimmunity.

Annals of neurology, 2017-07

Expanded phenotypes and outcomes among 256 LGI1/CASPR2-IgG-positive patients.

The New England journal of medicine, 2013-03-21

Closure of patent foramen ovale versus medical therapy after cryptogenic stroke.

Neurology, 2013-08-13

An index to identify stroke-related vs incidental patent foramen ovale in cryptogenic stroke.

The New England journal of medicine, 2017-09-14

Long-Term Outcomes of Patent Foramen Ovale Closure or Medical Therapy after Stroke.

Circ Cardiovasc Interv, 2022 Jun 23

Transcatheter Closure of Patent Foramen Ovale in Older Patients With Cryptogenic Thromboembolic Events.

JAMA, 2021 Dec 14

Heterogeneity of Treatment Effects in an Analysis of Pooled Individual Patient Data From Randomized Trials of Device Closure of Patent Foramen Ovale After Stroke.

JAMA Neurol, 2020 Jul 01

Proposal for Updated Nomenclature and Classification of Potential Causative Mechanism in Patent Foramen Ovale-Associated Stroke.

JAMA Neurol, 2022 Nov 01

Association of Atrial Septal Aneurysm and Shunt Size With Stroke Recurrence and Benefit From Patent Foramen Ovale Closure.

Circulation, 2016-11-22

Recommendations for Management of Clinically Significant Drug-Drug Interactions With Statins and Select Agents Used in Patients With Cardiovascular Disease: A Scientific Statement From the American Heart Association.

JAMA, 2022 Apr 26

Aspirin Use to Prevent Cardiovascular Disease: US Preventive Services Task Force Recommendation Statement.

Lancet (London, England), 2018-08-04

Effects of aspirin on risks of vascular events and cancer according to bodyweight and dose: analysis of individual patient data from randomised trials.

Lupus, 2024 Jan 16

Complement C4d as a biomarker for systemic lupus erythematosus and lupus nephritis.

Arthritis care & research, 2022 Feb 08

A 79-Year-Old Female Patient With Altered Mental Status and Anemia.

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