4610897?1393869202
Joseph Sclafani, M.D.  
Male, 34
Richmond, VA

Interests: Internal Medicine, arrhythmia
My Posts
1 hour in the Internal Medicine Expert Forum - 2
Hello. thank you for your question. A GFR>60 indicates normal renal function. Some patients have high normal serum creatinine for a number of reasons including age and increased muscle mass. This does not indicate impending renal failure. In regards to spleen size, it may indicate a hematologic problem. If your spleen was enlarged you could ask your ...
17 hours in the Internal Medicine Expert Forum - 1
Hello. Thank you for your question. The majority of ribes exposures occur from animal bites. However, there have been cases when bites are not involved. One such example is the virus being aerosolized in bat caves. I am not aware of rabies being spread from saliva left on food. The 4 major animal resevoirs has been reported to be bats, raccoons, skunks,...
Apr 20, 2014 in the Internal Medicine Expert Forum - 1
Hello. Thank you for yoru question. Pruritis, or intense itching, can occur in the first week after being infected. Rash and joint pain often occur in second week. Typically the body is able is able to mount an immune response 10 to 14 days after infection, at which point the viremia (virus in blood) resolves. -Dr. S
Apr 20, 2014 in the Internal Medicine Expert Forum - 1
Hello, thank you for your question. Most cases of viral gastroenteritis are self-limiting and get better in 2-3 days. I tell most patients to avoid contact until at least the symptoms resolve and possibly 1-2 days after in case the family member is still shedding virus.
Mar 31, 2014 in the Heart Rhythm Expert Forum - 4
Hello. Thank you for your question. Ventricular tachycardia, or VT, has a few potential causes. Coronary artery disease, or blockages in the arteries that supply the heart, is a common cause. That is why a stress test was ordered, to try and diagnose this as a potential problem. Another potential cause is a cardiomyopathy, or damage to the squeezing functi...
Mar 26, 2014 in the Internal Medicine Expert Forum - 1
Hello. Thank you for your question. Unfortunately, there is not a substitute for seeking care with a physician with a physical exam. I would be concerned about your propensity for soft tissue infections such as MRSA if you have an abscess in a different part of your body. Very Respectfully, Dr. S
Hello. Thank you for your question. If a patient of mine told me those readings I would tell him or her those are normal readings and he or she has nothing to worry about. I would recommend no dietary changes to them. I am not aware of lemon affecting blood pressure. Very Respectfully, Dr. S
Mar 19, 2014 in the Heart Rhythm Expert Forum - 1
Hello thank you for your question. If one of my patients asked if they should continue their home medications to include Atenolol in the presence of a dental procedure using Lidocaune and epinephrine I would go ahead and tell them to take the Atenolol. Very Respectfully, Dr. S
Mar 19, 2014 in the Heart Rhythm Expert Forum - 1
Hello. Thank you for your question. Technically a pulse rate of 99 beats per minute (bpm) does not constitute tachycardia or a rapid pulse rate. Also, if she was asymptomatic, I do not believe you need to look into the matter any further. Very Respectfully, Dr. S
Hello. Thank you for your question. Often times, patients may feel lightheaded or dizzy after standing. This is often due to a drop in blood pressure, not a rise in blood pressure. This is called orthostatic hypotension. Patients with this issue should be evaluated with orthostatic vital signs in their physician's office. Here, pulse and blood pressur...