If you've done MBBS :You are in top 0.1% of the population
If you've done MD after MBBS: You are in the top 0.01% of the population
If you've done DM after MD,MBBS: You need to get a life
Daraxonrasib- The new weapon in the armamentarium against pancreatic cancer is creating ripples across the med onc community
I would like to take this opportunity to remind you how incredible Oncology residency is:
In the 1 st year ,you hear about the names of all these fascinating drugs
In the 2nd year , you learn how to pronounce the names of all these drugs
In the 3rd year , you understand how to prescribe all these fantastic molecules
And after you pass out, you get to know that all these "fascinating" drugs have become redundant..and you go back to learning how to pronounce these new drugs again
There is no test in the world to differentiate between SIADH and CSW
The only way you can come to a conclusion is by giving a trial of fluids and see the response
If the patient improves its spot on Cerebral Salt Wasting and if the patient deteriorates it is multiple Consumer court visits
In the face of global unrest , India is facing a severe shortage of platinum agents
It is a sad time for most oncology centres EXCEPT for that one institute we all know that will come out with the SUBPLAT trial-" Substitution of platinum drugs with other chemotherapy agents in war affected areas- A real world study of 1000 patients" ☠️
1. High CRP /procalcitonin = infection
2. Low CRP/procalcitonin = no infection
3. ESR is useful
4. Granuloma = TB
5. Flucloxacillin is superior to cefazolin
6. Antibiotics prevent infection (infection prevention prevents infection: mainly hand hygiene)!
7. Perhaps contrast-induced nephropathy (not my area of expertise)
8. You need three drugs to treat HIV (not a major issue, but two will mostly do just fine)
9. Pyuria = UTI
10. Bacteriuria = UTI
11. Positive BAL/sputum/tracheal tube cultures = pneumonia
12. You need cephalexin (use cefadroxil)!
***
And as always
-Longer is better
-IV > oral
One of the BIGGEST sources of confusion of diuretic therapy with ascites is getting the dosing wrong.
For CHF spironolactone is 25 mg. In Ascites we START at 100 mg and go to maximum of 400 a day.
Furosemide is added with 40 mg and maximum 160 mg
If you are single you often feel left out ,unhappy , sometimes even miserable
You are unable to thrive, blossom and reach your full potential !
That is why Myeloma decided to not be single . It chose to be multiple- Multiple myeloma, multiple lesions ,multiple tumors
It decided to be savage af and wreak havoc 😈
Sometimes you have to give Indomethacin to control fever
Sometimes you have to give octreotide to stop diarrhea
Sometimes you have to do bone marrow biopsy before the full blood workup:
A naive physician goes only by the guidelines
But A shrewd physician does not let guidelines limit him
Guess who thrives in the real world outside of medical colleges?