Family Practice Notebook Updates

Aka: Family Practice Notebook Updates, FPN Updates

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II. Updates: July 2025

  1. Pericardial Effusion (cv, Pericardium)
    1. Updates
  2. Superior Vena Cava Obstruction (cv, vessel)
    1. Updates
  3. Skin Infections in Diabetes Mellitus (derm, endo)
    1. Updates
  4. Knuckle Pad (derm, hyperplasia)
    1. Added
  5. Vesicle (derm, exam)
    1. Updates - Corrected misspelling of Vesicle in many entries
  6. Adrenal Insufficiency (endo, adrenal)
    1. Updates
  7. Short Stature (endo, growth)
    1. Updates
  8. Tall Stature (endo, growth)
    1. Updates
  9. Hand Foot and Mouth Disease (ent, mouth)
    1. Updates
  10. Herpangina (ent, mouth)
    1. Updates
  11. Boric Acid Toxicity (er, toxin)
    1. Updates
  12. Giardia (gi, id)
    1. Updates
  13. Cryptosporidium (gi, id)
    1. Updates
  14. Entamoeba histolytica (gi, Diarrhea)
    1. Updates
  15. Endometrial Cancer (gyn, hemeonc)
    1. Updates
  16. Tumor Lysis Syndrome (hemeonc, pharm)
    1. Updates
  17. Immune Effector Cell-Associated Neurotoxicity Syndrome (hemeonc, pharm)
    1. Added
  18. Apheresis (hemeonc, procedure)
    1. Added, along with related definitions
  19. Oncologic Emergency (hemeonc, sx)
    1. Updates
  20. Neutropenic Fever (id, hemeonc)
    1. Updates
  21. Adenovirus (id, virus)
    1. Updates
  22. Arbovirus (id, virus)
    1. Updates
  23. Arenaviridae (id, virus)
    1. Added
  24. Astrovirus (id, virus)
    1. Added
  25. Bunyaviridae (id, virus)
    1. Added
  26. Coxsackie Virus B (id, virus)
    1. Added
  27. Filovirus (id, virus)
    1. Added
  28. Flaviviridae (id, virus)
    1. Added
  29. Papovaviridae (id, virus)
    1. Added
  30. Picornaviridae (id, virus)
    1. Added
  31. Poxviridae (id, virus)
    1. Added
  32. Norovirus (id, virus)
    1. Updates
  33. Rabies (id, virus)
    1. Updates
  34. Reoviridae (id, virus)
    1. Added
  35. Rotavirus (id, virus)
    1. Updates
  36. Smallpox (id, virus)
    1. Updates
  37. Togaviridae (id, virus)
    1. Added
  38. Chronic Granulomatous Encephalitis (neuro, id)
    1. Added
  39. Primary Amebic Meningoencephalitis (neuro, id)
    1. Updates
  40. Anti-Amyloid Beta Plaque Monoclonal Antibody (neuro, pharm)
    1. Updates
  41. Epidural Neoplasm (ortho, hemeonc)
    1. Updates
  42. Hand Infection (ortho, id)
    1. Updates
  43. Hypercalcemia of Malignancy (renal, hemeonc)
    1. Updates
  44. SIADH (renal, Sodium)
    1. Updates
  45. Acute Monoarthritis (rheum, joint)
    1. Updates
  46. Chronic Opioid (rheum, pain)
    1. Updates
  47. Pigmented Villonodular Synovitis (rheum, hemeonc)
    1. Added
  48. Nocturia (urology, sx)
    1. Updates

III. Updates: June 2025

  1. Right Bundle Branch Block (cv, ekg)
    1. Updates
  2. Internal Hernia (endo, surgery)
    1. Updates
  3. PECARN Pediatric Intra-Abdominal Injury Algorithm (er, exam)
    1. Updates
  4. Tracheal Suction (er, procedure)
    1. Updates
  5. Political Protest Injury (er, Trauma)
    1. Added
  6. Conducted Energy Weapon (er, Trauma)
    1. Added
  7. Kinetic Impact Projectile Injury (er, Trauma)
    1. Added
  8. Riot Control Agent (er, Trauma)
    1. Updates
  9. Concussion (er, neuro)
    1. Updates regarding TBI lab markers
  10. Hepatitis B Virus (gi, liver)
    1. Updates to HBV, Hepatitis B Serology and Hepatitis B Carrier
  11. Oncogene (hemeonc, id)
    1. Added
  12. PFAS Chemical (hemeonc, prevent)
    1. Added
  13. Sickle Cell Crisis (hemeonc, sickle)
    1. Corrections on Reticulocyte Count (thanks to Dr. Mark Khalil)
  14. Upper GI Bleed (gi, sx)
    1. Updates related to children
  15. Lower GI Bleed (gi, sx)
    1. Updates related to children
  16. Postmenopause (gyn, endo)
    1. Updates
  17. Female Sexual Dysfunction (gyn, psych)
    1. Updates
  18. HTLV1 (hiv, exam)
    1. Added
  19. HIV Pathophysiology (hiv, exam)
    1. Extensive Updates
  20. HIV Staging (hiv, exam)
    1. Updates
  21. HIV Labs (hiv, lab)
    1. Updates
  22. HIV Postexposure Prophylaxis (hiv, prevent)
    1. Biktarvy is now preferred as single tablet once daily for 28 days
  23. Sepsis (id, fever)
    1. Updates on Esmolol in the prevention of septic Cardiomyopathy related to persistent Sinus Tachycardia
  24. Vaccine (id, immunize)
    1. Updates
  25. Herpesviridae (id, virus)
    1. Updates
  26. Herpes Simplex Virus (id, virus)
    1. Updates
  27. Venous Blood Sampling (lab, hemeonc)
    1. Updates
  28. Obstructive Sleep Apnea in Children (lung, peds)
    1. Updates
  29. Dementia (neuro, cognitive)
    1. Updates
  30. Migraine Headache Prophylaxis (neuro, Headache)
    1. Updates
  31. Trigeminal Neuralgia (neuro, Headache)
    1. Updates
  32. Lamotrigine Toxicity (neuro, pharm)
    1. Updates
  33. Cordyceps (pharm, alternative)
    1. Updates
  34. Naloxone (pharm, Analgesic)
    1. Updates
  35. Ketorolac (pharm, Analgesic)
    1. Updates
  36. Pediatric Analgesic (pharm, peds)
    1. Updates
  37. Radial Head Fracture (ortho, elbow)
    1. Updates
  38. Rib Fracture (ortho, lung)
    1. Updates
  39. Xylazine Toxicity (psych, cd)
    1. Updates
  40. Zuranolone (psych, pharm)
    1. Updates
  41. Juvenile Idiopathic Arthritis (rheum, peds)
    1. Updates
  42. Occupational Injury (sports, work)
    1. Updates
  43. Digital Block (surgery, Anesthesia)
    1. Updates

IV. Updates: May 2025

  1. Accelerated Junctional Tachycardia (cv, ekg)
    1. Updates
  2. Chromoblastomycosis (derm, Fungus)
    1. Added
  3. Erythrasma (derm, Bacteria)
    1. Updates
  4. Tirzepatide (endo, pharm)
    1. Updates regarding OSA indication
  5. Hourly Subcutaneous Insulin (endo, pharm)
    1. Updates
  6. Laryngeal Fracture (ent, Larynx)
    1. Updates
  7. Traumatic Brain Injury (er, neuro)
    1. Updated mild, moderate and severe brain injury with their associated BIG 1, 2, 3 criteria
  8. Rectal Drug Delivery Route (er, pharm)
    1. Added
  9. Open Angle Glaucoma (eye, Glaucoma)
    1. Updates to medications
  10. Lateral Canthotomy (eye, procedure)
    1. Updates
  11. Eosinophilic Esophagitis (gi, Esophagus)
    1. Updates
  12. Hepatic Encephalopathy (gi, neuro)
    1. Updates
  13. Premenstrual Syndrome (gyn, psych)
    1. Updates
  14. Cutaneous B-cell Lymphoma (hemeonc, lymph)
    1. Added
  15. Antiplatelet Therapy for Vascular Disease (hemeonc, pharm)
    1. Updates
  16. Fungal Infection (id, Fungus)
    1. Added
  17. Mucormycosis (id, Fungus)
    1. Added
  18. Candidiasis (id, Fungus)
    1. Updates
  19. Tetracyclines (id, pharm)
    1. Updates regarding safety in pregnancy, Lactation and children
  20. Influenza (id, virus)
    1. Updates
  21. Measles (id, virus)
    1. Updates
  22. Metapneumovirus (id, virus)
    1. Added
  23. Parainfluenza VIrus (id, virus)
    1. Added
  24. Paramyxovirus (id, virus)
    1. Added
  25. COPD Exacerbation Antibiotics (lung, copd)
    1. Updates
    2. Thanks to Dr. Mark Khalil for email feedback
  26. Aspergillosis (lung, Fungus)
    1. Updates
  27. AI Virtual Scribe (manage, computer)
    1. Added
  28. Acute Migraine Headache (neuro, Headache)
    1. Updates
  29. Unintended Pregnancy (ob, antepartum)
    1. Updates
  30. RhoGAM (ob, pharm)
    1. RhoGAM is NOT required for Miscarriage or abortion <12 weeks gestation per ACOG 2024
    2. However, RhoGAM is still recommended in Ectopic Pregnancy <12 weeks or when dates are uncertain
  31. Ginkgo Biloba (pharm, alternative)
    1. Updates
  32. Topical Fluoride (pharm, minerals)
    1. Updates
  33. Food Dye (pharm, nutrition)
    1. Added
  34. Opioid Use Disorder (psych, cd)
    1. Updates
  35. Psychosis (psych, Psychosis)
    1. Updates
  36. Groin Injuries in Athletes (ortho, sx)
    1. Updates
  37. Nursemaid's Elbow (ortho, elbow)
    1. Hyperpronation technique is most effective reduction (more evidence)
  38. Cervical Spine Imaging in Acute Traumatic Injury (ortho, rad)
    1. Updates
  39. Ginseng (pharm, alternative)
    1. Updates
  40. Urinary Catheterization (urology, procedure)
    1. Updates

V. Updates: April 2025

  1. Oral Mucosa Hyperpigmentation (derm, pigment)
    1. Updates
  2. GLP1 Agonist (endo, pharm)
    1. Updates regarding gastrointestinal effects and Malnutrition risk
  3. Insulinoma (endo, Hypoglycemia)
    1. Updates
  4. Mastoiditis (ent, ear)
    1. Updates on Antibiotic management
  5. Epistaxis (ent, nose)
    1. Updates with TXA related evidence
  6. Hypothermia (er, environ)
    1. Updates regarding progressive EKG changes
  7. Cardiopulmonary Resuscitation (er, exam)
    1. Updates regarding pulse checks
  8. Trichloroethylene Poisoning (er, toxin)
    1. Added
  9. Radiation Exposure (er, weapon)
    1. Updates
  10. Central Retinal Artery Occlusion (eye, cv)
    1. Updates
  11. Barrett Esophagus Cancer Risk Score (gi, exam)
    1. Added
  12. Alcoholic Liver Disease (gi, liver)
    1. Updates
  13. Bacterial Vaginosis (gyn, id)
    1. Updated with refractory/recurrence co-treatment of male sexual partner with Flagyl oral and Clindamycin Topical
    2. Thank you to Nate D for bringing a new article from NEJM to my attention
  14. Chronic Pelvic Pain (gyn, sx)
    1. Updates
  15. Paraneoplastic Syndrome (hemeonc, endo)
    1. Added
  16. Sickle Cell Disease (hemeonc, Hemoglobin)
    1. Extensive updates including adding several subtopics
  17. Blood Culture (id, lab)
    1. Updates
  18. Mycobacteria (id, Bacteria)
    1. Updates
  19. Mycoplasma (id, Bacteria)
    1. Updates to Mycoplasma pneumonia and Ureaplasma Urealyticum
  20. Leprosy (id, Bacteria)
    1. Updates, including adding Clofazimine
  21. Syphilis Serology (id, lab)
    1. Extensive updates including Treponemal Specific Test, Non-Treponemal Test and Dark-field Microscopy
  22. Anti-Ribosomal Antibiotic (id, pharm)
    1. Updates to Macrolides, Tetracyclines, Aminoglycosides and other Anti-Ribosomal Antibiotics
  23. Beta Lactams (id, pharm)
    1. Updates to Penicillins, Cephalosporins, Carbapenems and Aztreonam
  24. Travel Preparation (id, travel)
    1. Updates to this and various related topics
  25. Rabies (id, virus)
    1. Updates
  26. Enzyme Activity (lab, exam)
    1. Added enzyme type image
  27. Clofazimine (lung, pharm)
    1. Added
  28. Acute Bronchitis (lung, rhonchi)
    1. Updates
  29. Susceptible Tuberculosis Treatment (lung, tb)
    1. Updates to this and Active Tuberculosis related to the shorter 4 month course with Moxifloxacin
  30. Down Syndrome (neuro, Disability)
    1. Updates
  31. Temporal Artery Biopsy (neuro, eye)
    1. Updates regarding Ultrasound
  32. Vertebral Osteomyelitis (ortho, id)
    1. Updates
  33. Wrist XRay (ortho, rad)
    1. Added Lateral XRay image
  34. Pectoralis Major Muscle Rupture (ortho, Shoulder)
    1. Added
  35. Pacifier (peds, behavior)
    1. Updates
  36. Kratom (pharm, alternative)
    1. Added
  37. Suzetrigine (pharm, Analgesic)
    1. Added
  38. Medication Patch (pharm, metabolism)
    1. Updates
  39. Religious Fasting During Ramadan (pharm, nutrition)
    1. Updates
  40. Trauma Informed Care (psych, anxiety)
    1. Added
  41. Lithium Toxicity (psych, pharm)
    1. Updates
  42. Prevention of Kidney Disease Progression (renal, prevent)
    1. Incorporated KDIGO 2024 recommendations
  43. Interscalene Block (surgery, pharm)
    1. Updates

VI. Updates: March 2025

  1. Atrial Fibrillation (cv, ekg)
    1. Updates
  2. Mobitz II AV Block (cv, ekg)
    1. Updates
  3. Vagal Maneuver (cv, procedure)
    1. Updates
  4. POTS Syndrome (cv, exam)
    1. Updates regarding aerobic Exercise in its management
  5. Genital Wart (derm, wart)
    1. Updates
  6. Cat Scratch Disease (er, bite)
    1. Updates
  7. Gastric Cancer (gi, hemeonc)
    1. Extensive updates
  8. Helicobacter Pylori (gi, id)
    1. Updated H. pylori treatment again based on ACG 2024
  9. Bowel Preparation (gi, procedure)
    1. Updates
  10. Menorrhagia (gyn, Menses)
    1. Updates
  11. Enoxaparin (hemeonc, pharm)
    1. Updates
  12. Acinetobacter Baumannii (id, Bacteria)
    1. Added aerobic gram negative Nosocomial Infection
  13. Brucellosis (id, Bacteria)
    1. Updates
  14. Burkholderia Cepacia (id, Bacteria)
    1. Added aerobic gram negative Nosocomial Infection
  15. Chlamydiaceae (id, Bacteria)
    1. Updates including to Trachoma, Inclusion Conjunctivitis, Chlamydial Urethritis, Psittacosis, TWAR
  16. Pseudomonas Aeruginosa (id, Bacteria)
    1. Added
  17. Q Fever (id, Bacteria)
    1. Updates
  18. Rickettsiae (id, Bacteria)
    1. Updates to this and the associated diseases
  19. Stenotrophomonas Maltophilia (id, Bacteria)
    1. Added aerobic gram negative Nosocomial Infection
  20. Trench Fever (id, Bacteria)
    1. Added
  21. Haemophilus Influenzae (id, Bacteria)
    1. Added, and updated Haemophilus Influenzae Pneumonia, Hib Vaccine
  22. Yersinia Pestis (id, Bacteria)
    1. Updates
  23. Francisella Tularensis (id, vector)
    1. Updates
  24. Bordetella Pertussis (lung, Bacteria)
    1. Updates
  25. Legionella (lung, Bacteria)
    1. Updates
  26. First Seizure Evaluation (neuro, Seizure)
    1. Updates
  27. Status Epilepticus (neuro, Seizure)
    1. Updates
  28. Growth Plate (ortho, anatomy)
    1. Updates
  29. Plantar Fasciitis (ortho, foot)
    1. Updates
  30. Epiphyseal Fracture (ortho, Fracture)
    1. Updates
  31. Acute Osteomyelitis
    1. Updates (ortho, id)
  32. Pediatric Leg Disorder (ortho, peds)
    1. Extensive updates including related topics (Intoeing, Out-toeing, Genu Valgum, Genu Varum)
  33. Toxic Synovitis (ortho, peds)
    1. Updates
  34. Sudden Infant Death Syndrome (peds, er)
    1. Updates
  35. Alpha Lipoic Acid (pharm, alternative)
    1. Added
    2. Not recommended in Diabetic Neuropathy due to low efficacy
  36. Refractory Depression Management (psych, depression)
    1. Psilocybin is slightly better than Placebo in Major Depression
  37. Metabolic Acidosis (renal, acidbase)
    1. Updates
  38. Metabolic Alkalosis (renal, acidbase)
    1. Updates
  39. Arterial Blood Gas Interpretation (renal, lab)
    1. Updates
  40. Suprapubic Bladder Aspiration (urology, procedure)
    1. Added
  41. Phimosis (urology, penis)
    1. Updates regarding Topical Corticosteroid protocol

VII. Updates: February 2025

  1. QTc Prolongation (cv, exam, ekg)
    1. Updates
  2. Myocardial Infarction with Nonobstructive Coronary Arteries (cv, cad)
    1. Added
  3. Cardiac Amyloidosis (cv, Myocardium)
    1. Added
  4. Electrocardiogram in Children (cv, peds)
    1. Added
  5. Clonidine Overdose (cv, pharm)
    1. Updates for the related Imidazoline Poisoning
  6. Vasopressin (cv, pharm)
    1. Updates
  7. Oral Health in Children (dental, prevent)
    1. Updates
  8. Acute Sinusitis (ent, sinus)
    1. Updates
  9. Copper Poisoning (er, toxin)
    1. Added
  10. Seat Belt Sign (er, Trauma)
    1. Updates
  11. Acute Vision Loss (eye, sx)
    1. Updates
  12. Campylobacter jejuni (gi, id)
    1. Updates
  13. Vibrio Cholerae (gi, id)
    1. Updates
  14. Vibrio parahaemolyticus (gi, id)
    1. Added
  15. Yersinia enterocolitica (gi, id)
    1. Updates
  16. Pediatric Reflux (gi, peds)
    1. Updates
  17. Sickle Cell Anemia (hemeonc, Hemoglobin)
    1. Updates to various associated topics
  18. CVA Thrombolysis (hemeonc, pharm)
    1. TNK has low efficacy in minor stroke and is associated with increased CNS Hemorrhage risk
  19. Andexxa (hemeonc, pharm)
    1. Updates on efficacy (does not alter patient-oriented outcomes and higher thrombosis risk)
  20. Gram Negative Bacteria (id, Bacteria)
    1. Updates
  21. Enterobacter (id, Bacteria)
    1. Added
  22. Escherichia coli (id, Bacteria)
    1. Updates
  23. Klebsiella Pneumoniae (id, Bacteria)
    1. Added
  24. Proteus Mirabilis (id, Bacteria)
    1. Added
  25. Salmonella (id, Bacteria)
    1. Updates
  26. Serratia Marcescens (id, Bacteria)
    1. Added
  27. Shigella (id, Bacteria)
    1. Updates
  28. Yersinia Pestis (id, Bacteria)
    1. Updates
  29. Meningococcal Vaccine (id, immunize)
    1. Updates
  30. Sulopenem Etzadroxil and Probenecid (id, pharm)
    1. Added
  31. Neisseria gonorrhoeae (id, std)
    1. Updates
  32. Social Generation Category (manage, communication)
    1. Added
  33. Meningococcal Meningitis (neuro, id)
    1. Updates
  34. Carbidopa-Levodopa (neuro, pharm)
    1. Updates
  35. Luxatio Erecta (ortho, Shoulder)
    1. Updates
  36. Picky Eating (peds, behavior)
    1. Updates
  37. Thumb Sucking (peds, behavior)
    1. Updates
  38. Hyperimmune Bovine Colostrum (pharm, alternative)
    1. Added
  39. Pediatric Insomnia (psych, peds, sleep)
    1. Updates
  40. Factitious Disorder (psych, somatic)
    1. Updates
  41. Dysuria (urology, sx)
    1. Updates

VIII. Updates: January 2025

  1. Left Ventricular Outflow Obstruction (cv, chf)
    1. Updates
  2. Pediatric Hypertension (cv, peds)
    1. Updates
  3. Aprocitentan (cv, pharm)
    1. Added this Endothelin Receptor Antagonist, limited fourth line agent for Refractory Hypertension
    2. Requires REMS program enrollment to prescribe (Teratogenic)
  4. Endothelin Receptor Antagonist (cv, pharm)
    1. Added this class used primarily for Pulmonary Arterial Hypertension
  5. Exercise Stress Test (cv, procedure)
    1. Updated various stress tests
  6. Subungual Melanoma (derm, hemeonc)
    1. Updates
  7. Keloid (derm, hyperplasia)
    1. Updates to Keloid and Hypertrophic Scar
  8. Cutaneous Sporotrichosis (derm, id)
    1. Updates
  9. GLP-1 Agonist (endo, pharm)
    1. Added equivalent dosing for GLP-1 Agonists (to aid switching between agents)
  10. Cardiopulmonary Resuscitation (er, exam)
    1. Updates regarding Pediatric Resuscitation
  11. Listeria monocytogenes (gi, id)
    1. Updates
  12. Liver Function Test Abnormality (gi, lab)
    1. Updates to this and related topics
  13. Stress Ulcer (gi, pud)
    1. Updates regarding prophylaxis indications (need more than Mechanical Ventilation alone)
  14. Premenstrual Disorder (gyn, psych)
    1. Updates
  15. Direct Oral Anticoagulant Score (hemeonc, exam)
    1. Added
  16. Sickle Cell Anemia (hemeonc, hgb)
    1. Updates regarding Penicillin prophylaxis
  17. Pediatric Anemia (hemeonc, peds)
    1. Updates
  18. Anthrax (id, Bacteria)
    1. Updates
  19. Bacillus Cereus (id, Bacteria)
    1. Added
  20. Coryneform Bacteria (id, Bacteria)
    1. Added
  21. Corynebacterium diphtheriae (id, Bacteria)
    1. Updates
  22. Clostridium (id, Bacteria)
    1. Updated Clostridium botulinum, Clostridium tetani, Clostridium perfringens
  23. Rhodococcus equi (id, Bacteria)
    1. Added
  24. Streptococcus (id, Bacteria)
    1. Updates to Streptococcus, Group A Streptococcus, Group B Streptococcus
    2. Added Streptococcus Viridans Group
  25. Staphylococcus (id, Bacteria)
    1. Updates to Staphylococcus Aureus and MRSA
    2. Added Staphylococcus Epidermidis, Staphylococcus Saprophyticus
  26. Pneumococcal Conjugate Vaccine (id, immunize)
    1. Significant updates that simplify overall Pneumococcal Vaccine protocols
    2. All adults age 50 years and older are now vaccinated with 1 dose of PCV20 or PCV21
    3. Immunocompromised Adults age 18 to 50 years are also vaccinated with PCV20 or PCV21
    4. Children are still vaccinated with Primary Series with PCV20 until PCV21 is approved
  27. Quinine Toxicity (id, pharm)
    1. Added
  28. Advanced Airway in Children (lung, procedure)
    1. Updated failed airway in age <8 years: surgical Tracheostomy vs Needle Cricothyrotomy
  29. Cerebral Intraparenchymal Hemorrhage (neuro, cv)
    1. Updates
  30. Subarachnoid Hemorrhage (neuro, cv)
    1. Updates
  31. Duke Abdominal Assessment Scale (nicu, exam)
    1. Added as part of NEC evaluation
  32. Stress Fracture (ortho, Fracture)
    1. Updates
  33. Reverse Total Shoulder Arthroplasty (ortho, surgery)
    1. Updates
  34. Peppermint Oil (pharm, alternative)
    1. Updates
  35. Alcohol Withdrawal (psych, cd)
    1. Updates
  36. Septic Joint (rheum, id)
    1. Updates
  37. Pediatric Abdominal Pain (surgery, peds)
    1. Updates
  38. Priapism (urology, penis)
    1. Correction in Phenylephrine preparation, thanks to Nick Yarbrough, Emergency PharmD

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