Weekend Coverage – Welcome To

jacobi August 11, 2017August 11, 2017Asideannouncement, Weekend Coverageweekend coverage

Weekend Coverage 8/12 – 8/13

Announcement Off service notes: 8/16 will be intern switch day for ACS, Pulm and Neuro teams. Residents – please advise your interns to use the updated off-service-note template (click here to download). You can also find it in the Resident Share drive:\\[2017-2018] Note Template & Samples\[2017-2018] Off Service Note – Template.docxWe appreciate your feedback from our last group meeting and have edited the template so that it blends together the information that should be in a daily progress note, but with additional details that … Continue reading “Weekend Coverage 8/12 – 8/13”

jacobi August 3, 2017AsideTidbits, Weekend CoverageEducation, neuro

Neurological emergency

Hydrocephalus: if you see hydrocephalus in a patient with consistent severe headaches, this could be a sign of impending herniation. Patient will need emergent relief of intracranial pressure. Botulism: Rapidly progressive paralysis with blurry vision, sluggish pupils and diplopia. This condition is caused by an irreversible toxin and the antitoxin should be given as soon as possible, so needs high clinical suspicion. The diagnosis is by injecting patient’s serum in mice to see if it causes paralysis (takes a … Continue reading “Neurological emergency”

jacobi August 3, 2017August 9, 2017Tidbits, Weekend CoverageEducation, hyponatremia, renal

hyponatremia

Pathophysiology: Hyponatremia means excess of body water compared to total body sodium and potassium. Also likely to involve ADH (vasopressin), the hormone involved in water balance. Total osmolality: concentration of all solutes in a given weight of water (mOsm/kg) regardless of whether or not osmoles move across biological membranes Effective osmolality: number of osmoles that contribute to water movement between intracellular and extracellular compartments Most hyponatremia is from low effective osmolality (hypo-osmotic/hypotonic hyponatremia), but occasionally, hyponatremia occurs in isotonic … Continue reading “hyponatremia”

jacobi August 3, 2017August 3, 2017ImageTidbits, Weekend CoverageID, sepsis, toxoplasmosis, weekly image

weekly image 0803

39M from DR, h/o AIDS (CD4 = 40, VL 250k) not on HAART, p/w AMS, also have decreased ambulation/appetite/speaking/ambulation for 2 wks Vitals: 98.3/55/18 BP: 100/60 What is the differential diagnosis ? What to do for this patient ? From NEJM Teaching Topics | February 23, 2012 Q. What neoplastic processes are part of the differential diagnosis of a peripherally enhancing brain lesion? The differential diagnosis of a peripherally … Continue reading “weekly image 0803”

jacobi August 3, 2017August 11, 2017Asideannouncement, Weekend Coverageweekend coverage

Weekend Coverage 8/5-6

Important Announcements Qmed downtime 8/4 – 5 Please note that there will be a Qmed upgrade overnight from 8/4 @ 11:45 PM to 8/5 @ 07:45 AM (hopefully will be done by 06:15 AM) . During the Qmed downtime house staff will be UNABLE to review charts or place orders in Qmed. For chart/lab review: Please use the Qmed downtime system (review these instructions) For ordering labs/medications: Unfortunately, all orders will need to be WRITTEN (order sheets are available at nursing stations on all the … Continue reading “Weekend Coverage 8/5-6”