12/4/19 Announcements

  Phew, it's been awhile since we have had an announcement post. First of all, thank you all for your diligence, positive attitude, and support of each other during this grueling holiday season / interview season. We appreciate you all! Also huge congrats to our Fellow matchers: Neha and Eshan!   Jeopardy Protocol: As we … Continue reading 12/4/19 Announcements

Tree-In-Bud(ding) Knowledge

Tree-in-bud sign or pattern describes the CT appearance of multiple areas of centrilobular nodules with a linear branching pattern. Although initially described in patients with endobronchial tuberculosis, it is now recognized in a large number of conditions. While the tree-in-bud appearance usually represents endobronchial spread of infection, given the closeness of small pulmonary arteries and small airways (sharing branching morphology-bronchovascular bundle), … Continue reading Tree-In-Bud(ding) Knowledge

Heyde’s Syndrome

Check out this cool vid from NEJM! "Blood flow through a stenotic aortic valve alters the conformation of high-molecular-weight von Willebrand factor and exposes sites on A2 domains that can be cleaved by the plasma protease ADAMTS13. Consequently, high-molecular-weight von Willebrand factor multimers are reduced in size and are hemostatically less competent than the intact … Continue reading Heyde’s Syndrome

9/6/19 Skimming the Scoop

Intern Retreat Update: We received the unfortunate news this week that funding for Whitewater raftering has been pulled. No worries though! We are still going to have a blast hanging out together, eating oysters and ice cream, and going kayaking! Lunch Conference Case Report: There will be no Intern Morning Report this coming Monday, 9/9. We will instead … Continue reading 9/6/19 Skimming the Scoop

Chagas Disease – your Sub-I was right!

Chagas disease is on the rise in the United States and becoming more widespread. Why? How do these patients present, and how do we make the diagnosis and then treat them appropriately? How can we prevent further transmission? In this segment, Drs. Mizuho Morrison and Neda Frayha review the ins and outs of Chagas disease, one of five neglected parasitic infections in the U.S. according to the CDC.

Adult-Onset Still Disease: Evanescent, Salmon-Colored Rash

Adult-onset Still Disease (AOSD) is a rare disorder that affects multiple organ systems. Symptoms and signs include daily high spiking fever, evanescent salmon-colored rash on the trunk and extremities, arthritis, lymphadenopathy, and leukocytosis. It is most commonly diagnosed in young adults (median age, 36 years) but has been described in older age groups. Some reports … Continue reading Adult-Onset Still Disease: Evanescent, Salmon-Colored Rash

8/9/19 What’s New, Doc?

Welcome Sadia and Sub-I's (Shana, Laura, and Steven)! Intern Morning Report: Intern Morning will be back next week and at least through September. We will likely gradually transition to Lunch Reports on Mondays in October. ICU Schedule: The ICU schedule is changing to improve the JICU rotation and make the Intern rotations more equitable. This … Continue reading 8/9/19 What’s New, Doc?

Surgery for Infective Endocarditis

The decision to pursue surgery for treatment of infective endocarditis is complex and requires a multidisciplinary approach. Early surgery (during hospitalization and before completion of an antimicrobial course) is recommended for patients with (1) symptomatic heart failure and valvular dysfunction; (2) left-sided infective endocarditis caused by fungal infections or highly-resistant organisms; (3) associated complications, such as annular or aortic abscess, destructive penetrating lesions, … Continue reading Surgery for Infective Endocarditis

8/2/19 The Newsies

Happy August Everybody! We have entered Cardiology Month. There are a ton of announcements this week: The Return of Teaching Tuesday: Hurray for the return of dedicated teaching/learning time! 8/5 Morning Report: There is no MR on 8/5 (enjoy the extra time to pre-round or sleep!). MR will happen during the lunch time slot instead. Medtrics … Continue reading 8/2/19 The Newsies

Tolvaptan (ADH Antagonist) and Hyponatremia

Indications: Heart Failure (NYHA class III and IV) and SIADH (especially if sodium has not responded to fluid restriction)  Contraindications: Hypovolemia, Anuria, Liver Impairment ***Do not use if you have to raise the sodium quickly!*** For more information regarding Tolvaptan: Read Here!

7/24/19 What’s New?

Case Report Sign-Up’s: Brandon has gotten us into the Case Report mood. Sign up here if you wish to do one!Kitchen Duty: The kitchen needs cleaning! Those on Jeopardy (Chris, Will, Tyler, Alan), please find time over the next week to keep the place spruced up!Intern/Resident Retreat: The Intern Retreat is set! Y'all are going … Continue reading 7/24/19 What’s New?

TPP and Hypokalemia

"Thyrotoxic periodic paralysis (TPP), a disorder most commonly seen in Asian men, is characterized by abrupt onset of hypokalemia and paralysis. The condition primarily affects the lower extremities and is secondary to thyrotoxicosis. It has been increasingly reported in the USA due to the rise in the immigrant population. Hypokalemia in TPP results from an … Continue reading TPP and Hypokalemia

Faget Sign: Hot Bod + Slow Heart

Faget Sign: Relative bradycardia in association with fever (Temperature-pulse dissociation). Originally described by Jean-Charles Faget in patients with yellow fever (1859). "Discordance entre la courbe du pouls et celle de la temperature dans la fièvre jaune." Subsequently observed in multiple febrile illnesses especially intracellular bacterial infections.

tPA: To Use or Not To Use

Treatment with intravenous recombinant tissue plasminogen activator (alteplase) within 3 hours of ischemic stroke onset is associated with a significant reduction in disability at 3 months after stroke; treatment within 4.5 hours of onset also may have clinical benefit but is not FDA approved.

ANDROMEDA-SHOCK and The Bottom Line

How do you know it's a good day in Chiefland? The sun is shining, the birds are chirping, and we're spending our time going over Tyler Denman's incredible Noon Conference on Sepsis and reading up on one of the most recent landmark trials on Sepsis Management - ANDROMEDA SHOCK. If you, like us, sometimes struggle … Continue reading ANDROMEDA-SHOCK and The Bottom Line