Dr. Gerald Diaz @GeraldMD
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Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief 🇵🇭 🇺🇸 - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG: https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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EKG in Acute Pulmonary Embolism
The sensitivity and specificity for EKG findings in acute PE are low.
EKG
EKG in Acute Pulmonary ... EKG is helpful in ... evaluating for other causes ... #EKG #Pulmonary ... #diagnosis #cardiology
Hypotension / Shock Differential Diagnosis Algorithm
Hypovolemic:
 • Poor oral intake
 • Hemorrhage
 • Renal loss
 •
Differential Diagnosis ... Algorithm Hypovolemic ... embolism • Left ... #Algorithm #shock ... #causes
Shock - Differential Diagnosis by Classification

Hypovolemic (Intravascular volume depletion)
 - Hemorrhagic 
   • Trauma
contractility) - Acute ... exacerbation (any cause ... flow) - Massive pulmonary ... embolism - Pericardial ... Classification #Table
Pulmonary Embolism - Risk Stratification and Prognostication based on scores and clinical features

 • Bova score
Pulmonary Embolism ... class (30-day all cause ... Transient Hypotension, Shock ... prognostication #diagnosis ... #management #stratification
TiTrATE Approach to Vertigo
TiTrATE approach stands for Timing, Triggers and Targeted Examination.
4 vestibular syndromes that are
(eg BPPV, orthostatic ... (eg Menière's, ... (eg central cause ... ) #Titrate #algorithm ... #diagnosis #acute
Shock and Vasoactive Drugs 
1) Determine type and etiology of shock
 • Distributive: Sepsis, Anaphylaxis, Neurogenic
Pericardial tamponade, Pulmonary ... embolism 2) Understand ... #inopressors #diagnosis ... #management #comparison ... #table
Reflex Testing - Causes of Hyporeflexia and Hyperreflexia
Focal Hyporeflexia: 
 • Radiculopathy, Mononeuropathy, Polyneuropathy, Acute stroke,
Polyneuropathy, Acute ... stroke, Acute spinal ... polyneuropathy (e.g ... #differential #diagnosis ... #table #neurology
Shock - Differential Diagnosis Framework
 - MAP <65. SBP <90, drop in SBP > 40
 -
• Obstructive: Pulmonary ... Embolism, Tension ... Abdominal compartment syndrome ... #criticalcare #algorithm ... #treatment #management
Acute Kidney Injury (AKI) - Differential Diagnosis Framework
Pre-Renal:
 • Hypovolemia, Cardiorenal, Distributive Shock, HRS, Hypercalcemia, Renal
, Distributive Shock ... Abdominal Compartment Syndrome ... : • Vascular: Emboli ... #nephrology #causes ... #algorithm
Hyponatremia - Differential Diagnosis by Mechanism
Decr Blood Pressure (“Decr Effective Circulating Volume”) 
 - Volume depletion
- Cirrhosis Syndrome ... - Malignancy (e.g ... CNS pathology (e.g ... pathology (e.g. ... #Table #Causes