Today at morning report we had an interesting case of young patient with jaundice, pruritus, abdominal pain and weight loss. ANCA was positive. Following liver biopsy and MRCP the patient was diagnosed with primary sclerosing cholangitis and ultimately with Crohn's. We also discussed this great article from NEJM about DILI (nejmra1816149) which describes 3 patterns … Continue reading Primary sclerosing cholangitis causing intrahepatic cholestasis – morning report 7.31.2019
Today at Morning Report we discussed a patient who had a family history of thrombotic events, presenting with acute onset and worsening abdominal pain and later found to have superior mesenteric vein and portal vein thrombosis. Remember, acute mesenteric vein thrombosis presents similar to other mesenteric ischemias with non-specific central, peri-umbilical abdominal pain, classically described … Continue reading Abdominal Pain and Hypercoagulability – Morning Report 7.24.19
Today on our monthly clinical reasoning and physiologic mechanisms of disease lecture we discussed a case of classic heat stroke. These great articles about serotonin syndrome (nejmra041867) and heat stroke (nejmra1810762) were quoted and are both a highly recommended read!
Today at morning report we discussed a still evolving case of female patient with chest pain, shortness of breath and food impaction. She was diagnosed with NSTEMI (possibly type II) and possible RA thrombus. A couple of interesting points: Glucagon is often given for food impaction at the ER although it's effectiveness if not well … Continue reading Morning report 7/17/2019
Today's noon lecture was about VT mechanisms by Dr. Hopson. These are his slides in case you want to review the ECGs again or just need to use the list of medications on the last slide! Internal Medicine VT Review 7-10-19
Today we had a interesting case of lithium toxicity with normal blood levels in an elderly patient. This interesting article describes the possible mechanism for it which we mentioned this morning: "In patients taking chronically high doses, lithium will accumulate at a level in CNS tissue that induces toxicity. If subsequent doses are missed, the … Continue reading Lithium Toxicity – Morning report (7/10/19)
Today (7.8.2019) Dr. Schlueter from the department of Pathology shared some of the department's protocols for transfusion reactions as well massive transfusion protocols. Her lecture is available here: IM residents Tx Rxns and MTP