70 TRANSAMINASE ELEVATION General Discussion The following discussion applies to mild elevations of liver transaminase levels (up to five times normal) in asymptomatic patients. The first step in the evaluation…

71 TREMOR General Discussion The first step in evaluating any patient with tremor is to characterize the tremor. All humans have physiologic tremor of the hands which may be enhanced…

72 URINARY INCONTINENCE General Discussion Urinary incontinence is caused by disturbance in the storage function, and occasionally in the emptying function, of the lower urinary tract. A continent sphincter mechanism…

69 TINNITUS General Discussion Tinnitus is an unwanted auditory perception of internal origin which is usually localized and rarely heard by others. Tinnitus may affect 10–15% of the US population…

68 THYROID NODULE General Discussion The prevalence of palpable thyroid nodules is 3–7% in North America. Thyroid nodules are more common in elderly persons, in women, in those with iodine…

66 TESTICULAR MASSES General Discussion When evaluating a scrotal mass, it should be classified as extratesticular or intratesticular, solid or cystic, and painless or painful. Masses which arise from the…

64 SYNCOPE General Discussion Syncope is a sudden, unexpected loss of consciousness associated with a loss of postural tone with spontaneous recovery. A syncopal event is one of the more…

62 SEIZURE General Discussion Seizures may be classified as localized (partial or focal) or generalized based upon clinical and electroencephalographic changes. A generalized seizure involves the cerebral hemispheres bilaterally and…

61 RHINITIS General Discussion Rhinitis can be practically viewed as a heterogeneous group of nasal disorders characterized by symptoms such as rhinorrhea, nasal congestion, nasal itching, and sneezing. These classic…