Do not request a Duplex scan as a first level test for lower limb arterial disease, in patients that are asymptomatic or with mild claudication. Measure instead the Ankle Brachial Index (ABI).

Do not perform Duplex scan or Chest CT scan as first level tests for patients that, according to Wells or Geneva score, have a low probability of Deep Venous Thrombosis (DVT). D-dimer determination has a high sensitivity as a first level test.

by | Oct 17, 2018

DVT and Pulmonary Embolism (PE) are very rare in the absence of elevated D dimer levels or specific risk factors. DVT of the lower limbs is a common disease and it is usually suspected in the presence of swelling. Swelling may be due to orthopedic, cardiac or...
Do not perform computed tomography (CT) or nuclear magnetic resonance imaging (MRI) of the brain to patients who have experienced transient loss of consciousness in the absence of other neurological symptoms and have normal neurological examination. Adapted from the American College of Physicians

Do not perform computed tomography (CT) or nuclear magnetic resonance imaging (MRI) of the brain to patients who have experienced transient loss of consciousness in the absence of other neurological symptoms and have normal neurological examination. Adapted from the American College of Physicians

by | Oct 17, 2018

In patients who have experienced a witnessed loss of consciousness, without the suspicion of seizure and in the absence of other neurological signs or symptoms, the probability that central nervous system damage is the cause is very low and imaging of the brain does...
Do not perform computed tomography (CT) or nuclear magnetic resonance imaging (MRI) of the brain to patients who have experienced transient loss of consciousness in the absence of other neurological symptoms and have normal neurological examination. Adapted from the American College of Physicians

Do not perform supra-aortic trunks ultrasound to patients who have experienced transient loss of consciousness in the absence of other neurological symptoms and with normal neurological examination. Adapted from the American Academy of Neurology.

by | Oct 17, 2018

A vertebrobasilar TIA (transient ischemic attack) can cause loss of consciousness, but it is always accompanied by neurological signs such as motor or sensory loss in the face and / or limbs, coordination impairment, homonymous lateral hemianopia, balance and gait...
Do not perform computed tomography (CT) or nuclear magnetic resonance imaging (MRI) of the brain to patients who have experienced transient loss of consciousness in the absence of other neurological symptoms and have normal neurological examination. Adapted from the American College of Physicians

Don’t recommend Amyloid PET (positron emission tomography) in asymptomatic individuals without cognitive impairment, even in the presence of a familiarity for dementia, and in subjects reporting deficits not confirmed by the neuropsychological evaluation.

by | Oct 17, 2018

Amyloid PET is not a diagnostic test for Alzheimer’s disease but rather an index of cerebral amyloidosis, and may be positive in other forms of dementia (i.e. dementia with Lewy bodies), and in asymptomatic subjects. Furthermore, the accuracy of this exam decreases...