Primary care
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Volume and electrolyte evaluation and management is seen frequently in primary care practices. Some of the most common abnormalities encountered in outpatient practices are prerenal azotemia, dysnatremias, and altered potassium levels. Perturbations in volume or electrolyte concentrations can lead to serious organ dysfunction as well as hemodynamic collapse. This review focuses on the maintenance and regulation of intravascular volume and electrolytes, specifically sodium and potassium.
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Chronic kidney disease is encountered by the primary care physician, in no small part owing to the high rates of hypertension and diabetes, the 2 most common etiologies of chronic kidney disease in the United States. As a primary care physician, it is important to understand the epidemiology, pathophysiology, and evaluation methods of chronic kidney disease even before a referral to nephrology. Additionally, the primary care physician plays a vital role in mitigating the risks of chronic kidney disease as well as the complications and comorbidities.
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The details of vaccine development, licensing, and monitoring have never been more important and relevant to the health care conversation in the United States. The potential exists for a preventive medicine such as a vaccine to cause harm, and physicians and patients need to understand the real balance of risks and benefits of immunization. Vaccines given in the United States undergo rigorous testing before licensure as well as extensive postlicensure safety monitoring.