A reminder - someone with sickle cell disease cannot be diagnosed with diabetes using glycated haemoglobin or HbA1c. ๐งต
The โAโ in HbA1c denotes HbA and people with sickle cell disease donโt make HbA they only make HbS.
Now if you send an HbA1c sample to the lab anyway you may or may not get a result backโฆ
Attending on the inpatient oncology consult service is such a harrowing experience. It reinforces to me every time I do it that humans with end stage cancer should not spend the end of their life in the hospital #onctwitter#MedTwitter
#TipsForNewDocs
If the only justification you can muster for ordering a test is "the results would be of academic interestโ or โI just want to know,โ then don't order the test.
#kittlesonrules
๐ 20 studies that Internal Medicine Residents should read in the first year ๐
1/ ๐โโ๏ธ RACE II trial: Lenient resting HR < 110 was non-inferior to a strict HR < 80 in patients with atrial fibrillation.
๐งต
How do you check iron deficiency??
Medicine residents!!!!
Dont waste resources.
Just do ferritin levels. It tells you stores of iron in body. Thats it. If its less than 50, replace iron oral/iv. If above expect iron levels are fine.
However as ferritin is acute phase reactant, in inflammatory or acute stress state, you may get a falsely high ferritin. So check rest of profile. Iron saturation less than 20 and raised TIBC ( Increased binding due to low iron levels) signifies iron deficiency.
So you check ONLY ferritin levels in most cases. Only in case of clinical suspicion of underlying acute phase/inflammatory process, get the rest of it done.
If no anemia, its iron deficiency, if anemia its iron deficiency anemia.
Do you treat iron deficiency only with no anemia? Yes patient may experience tiredness etc and also depleted stores will finally lead to IDA.
ORAL give Iron elemental 65 mg one tablet alternate day.
In adults, average weight of 70 kg give IV 1000mg infusion once thats it.
Bye
I witnessed an LAPD officer giving an unhoused man a ticket for drinking in public. He said to the cop: "Well, of course I am drinking in public, I live in public and I'm poor. Where else can I drink if not here?" as the cop wrote up a ticket he'll never be able to pay.
excessive red tape surrounding methadone harms patients.
even on the inpatient side, it's much easier to order high-dose IV hydromorphone than it is to order methadone.
Simple twice a day walks for hospitalized patients was very effective at preventing declines in life space mobility. One of my favoriate Geriatrics studies https://t.co/WGRKrWuH1q