@jb_katz Just saw one as MICU consult. Lactate 4.5ish. N/V + abd pain. CT AP with anasarca. POCUS with LVEF ~10%. Went to CCU but did well with just afterload reduction and diuresis.
You asked and we delivered! Our popular Medical Mysteries series is back! Hear from E. Ashley Hardin, M.D. as she shares the mystery this year. What's your diagnosis? Check back in later this afternoon for the big reveal. #WhatsYourDiagnosis
#MedBits 2
For patients with acute exacerbations of chronic obstructive pulmonary disease who have contraindications to systemic steroids, what alternative medication, route, and dose would provide similar anti-inflammatory effects?
@lucypgeridoc@WilliamAird4 I’ve seen point 2 not infrequently and the only thing I could find is a possibility of decreased platelet function (despite many having thrombocytosis)
I’m starting a series called #MedBits, where I’ll share internal medicine-related questions that come up throughout residency. I hope to have people answer them, and I’ll post a summary of the responses, along with any answers I can find online, the following day.
#criticalcare and #nephrology X, how fast are you correcting severe symptomatic hyponatremia (<120) & what factors influence your rate of correction?
@jasonryanmd IM resident clinic at a large VA: asthma/copd, lots of chronic msk pain, mood disorders, substance use disorders, dementia, hypothyroidism, CKD, primary headache disorders, gout, peripheral neuropathy, & more
@DShaywitz@EvidenceOpen@UpToDate@zakkohane@Bob_Wachter@atulbutte In my experience it’s best for specific (more research oriented) questions. For clinical recommendations, it can often draw info from articles that are 10-20 years old. You have to be specific with wording to get good results. Still very helpful and I use it daily as a resident.