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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Shock Classification
Shock Definition: State of cellular and tissue hypoxia due to: reduced oxygen delivery, increased oxygen
embolism or severe ... pneumothorax, cardiac ... Classification #Types #diagnosis ... #management #cold ... warm #wet #dry #table
Reflex Testing - Causes of Hyporeflexia and Hyperreflexia
Focal Hyporeflexia: 
 • Radiculopathy, Mononeuropathy, Polyneuropathy, Acute stroke,
polyneuropathy (e.g ... Guillain-Barré syndrome ... Hyperthyroidism, Serotonin syndrome ... #differential #diagnosis ... #table #neurology
Shock - Differential Diagnosis Framework
 - MAP <65. SBP <90, drop in SBP > 40
 -
• Obstructive: Pulmonary ... Embolism, Tension ... Pneumothorax, Cardiac ... Abdominal compartment syndrome ... algorithm #treatment #management
Shock Types - Classification
State of cellular and tissue hypoxia due to: reduced oxygen delivery, increased oxygen
infarction, following cardiac ... embolism or severe ... pneumothorax, cardiac ... Classification #types #diagnosis ... #management #criticalcare
Shock - Differential Diagnosis by Classification

Hypovolemic (Intravascular volume depletion)
 - Hemorrhagic 
   • Trauma
Diagnosis by Classification ... 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
EKG in Acute Pulmonary Embolism
The sensitivity and specificity for EKG findings in acute PE are low.
EKG
EKG in Acute Pulmonary ... evaluating for other causes ... of cardio-pulmonary ... #EKG #Pulmonary ... #diagnosis #cardiology
Myocarditis
Diagnosis 
• Endomyocardial biopsy (gold standard, rarely performed) 
• Clinical presentation 
• Cardiovascular MRI 
Clinical 
•
Myocarditis Diagnosis ... Endomyocardial biopsy (gold ... • Cardiogenic shock ... , sudden cardiac ... #Management #Cardiology
Cardiac Stress Testing
Exercise:
 • Everyone who can exercise should!
 • They must be able to raise
• They must be able ... production to cause ... pts with severe COPD ... : EKG ($), ECHO ... #management #diagnosis
Hyponatremia - Differential Diagnosis by Mechanism
Decr Blood Pressure (“Decr Effective Circulating Volume”) 
 - Volume depletion
- Differential Diagnosis ... - Cirrhosis Syndrome ... hemorrhage) - Pulmonary ... pneumonia, COPD ... #Table #Causes