Hemolytic Anemias - Differential Diagnosis Algorithm Signs of anemia and hemolysis: • ↓ Haptoglobin • ↑ LDH • ↑ Indirect / unconjugated bilirubin • ↑ Reticulocytes • Abnormal peripheral smear Immune-mediated Hemolysis: • Autoimmune Hemolytic Anemias (AIHAs) • Alloimmune Hemolytic Anemias (AHAs) Nonimmune-mediated Hemolysis: • Extrinsic RBC Defects: Hypersplenism, Infection, Toxic, Mechanical, Macroangiopathic, Microangiopathic • Intrinsic RBC Defects: Membrane defects, Enzyme deficiencies, Hemoglobinopathies Matthew Ho, MD PhD @MatthewHoMD #Hemolytic #Anemias #Differential #Diagnosis #Algorithm #hematology

Intern Pocket Cards - Pharmacologic Pain Management Options Anti-inflammatory: • Acetaminophen (24 hours: < 3-4g in healthy adults, <3g in CKD, <2g in liver disease or cirrhosis) • Oral NSAIDs or IV ketorolac (avoid NSAIDs if CKD or >2 of the following risk factors: history of GI ulcer, age >60, on steroids, on ASA/anticoagulation) • Opioid: Hydrocodone, morphine, oxycodone, hydromorphone, fentanyl, tramadol, codeine • Topical: Lidocaine patch, menthol cream, lidocaine/prilocaine cream, capsaicin cream • Neuropathic agents: Gabapentin, pregabalin, SNRIs, TCAs • Anti-spasmodic: Baclofen, cyclobenzaprine, tizanidine Opioid Equianalgesia Conversion Table: • Morphine 10 IV, 25 PO • Hydromorphone 2 IV, 5 PO • Oxycodone 20 PO • Hydrocodone 25 PO • Codeine 100 IV, 200 PO • Fentanyl 0.15 IV • Tramadol 100 IV, 120 PO Dr. Satya Patel @SatyaPatelMD Full Inpatient Pocket Cards Collection: https://bit.ly/pocketcardset #Pain #Opioid #Conversion #Table #Ladder #medications #pharmacology #agents #internship #guide #comparison

Intern Pocket Cards - Inpatient Blood Pressure Management Guide ß-blockers: • Metoprolol, Carvedilol, Labetalol • Bradycardia, heart block, ADHF, COPD exacerbation ACEl/ARBs: • Captopril, Enalaprilat (IV), Lisinopril, Valsartan • AKI, hyperkalemia, angioedema Alpha-2 agonists: • Clonidine • Severe bradycardia Nitrates: • Isosorbide dinitrate • Severe AS, PDE inhibitor use Calcium Channel Blockers (CCBs): • Nifedipine ER, Diltiazem, Amlodipine • HFrEF, For non-dihydropyridines: Bradycardia, heart block Diuretics: • Chlorthalidone, Hydrochlorothiazide, Spironolactone • AKI, hypovolemia, difficulty with transferring to urinate Vasodilators: • Hydralazine • Can develop severe reflex tachycardia due to the unpredictable drop in SBP Non-selective alpha-blockers: • Phentolamine • Can develop severe reflex tachycardia due to the unpredictable drop in SBP Partial D1 agonists • Fenoldopam • Glaucoma Dr. Satya Patel @SatyaPatelMD Full Inpatient Pocket Cards Collection: https://bit.ly/pocketcardset #HTN #hypertension #BloodPressure #medications #Inpatient #pharmacology #table #agents #internship #comparison

Intern Pocket Cards - Electrolyte Repletion Guide Electrolyte Repletion: - Potassium (ref range 3.5-4.5) - Magnesium (ref range 1.3-1.7) - Calcium (ref range 8-10) - Phosphate (ref range 2.5-4.5) Dr. Satya Patel @SatyaPatelMD Full Inpatient Pocket Cards Collection: https://bit.ly/pocketcardset #Electrolyte #Repletion #Guide #management #inpatient #internship #potassium #phosphate #phosphorus #magnesium

Starting a new series for M3/4s & interns with @Noor4Neurology on some guidance before you consult on some common problems. First up: headaches! The workup of a patient with headache typically involves a systematic approach to rule out life threatening etiologies and identify the underlying cause and guide appropriate treatment. Here is a general outline of the workup process: #MedEd #MedTwitter #neurotwitter #Headache #Migraine #TensionHeadache #ClusterHeadache

ANCA Vasculitis - GPA, MPA, Eosinophilic GPA doi:10.1038/s41572-020-0204-y #ANCA #Vasculitis #GPA #MPA #Eosinophilic #rheumatology #diagnosis #comparison #table

Pathophysiology of Diabetic Ketoacidosis (DKA) and Hyperglycemic Hyperosmolar Syndrome (HHS) Absolute Insulin deficit: - Type I DM: No insulin produced - Type II DM pts under large stresses that ↑ insulin demand Relative Insulin deficit: - inadequate production, insulin resistance, non-adherence to insulin TX, stresses ↑ Insulin demand: infections, food binges, etc Hyperglycemia → Glucosuria → Polyuria → Dehydration → Electrolyte imbalance → Polydipsia #dka #hhs #pathophysiology #comparison #endocrinology #diabetes #diabetic #ketoacidosis #hyperglycemic #hyperosmolar

Problem Representation An evolving summary of a patient’s clinical presentation that strives to identify (1) Clinical syndrome (signs/symptoms), (2) Context (relevant history/demographics), and (3) Temporal pattern to maximize diagnostic signal. When to use? • One-liner at start of Assessment and Plan • Calling a consultant • Signing out a patient for cross coverage • Educating a team at a rapid response Full Inpatient Pocket Cards Collection: https://bit.ly/pocketcardset Dr. Anand Jagannath @AnandJag1 and Dr. Tyler Larsen @TylerLarsenMD #Problem #Representation #diagnosis #education #meded