Dr. Gerald Diaz @GeraldMD
29.7M 13.9K 7.3K
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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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 ... Embolism The sensitivity ... evaluating for other causes ... #EKG #Pulmonary ... #diagnosis #cardiology
Shock - Differential Diagnosis by Classification

Hypovolemic (Intravascular volume depletion)
 - Hemorrhagic 
   • Trauma
Diagnosis by Classification ... exacerbation (any cause ... flow) - Massive pulmonary ... embolism - Pericardial ... Classification #Table
Shock - Differential Diagnosis Framework
 - MAP <65. SBP <90, drop in SBP > 40
 -
• Obstructive: Pulmonary ... Embolism, Tension ... Abdominal compartment syndrome ... ) UOP > 0.5 cc/kg ... algorithm #treatment #management
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
Hypoxemic Respiratory Failure - Differential Diagnosis Framework
DECREASED INSPIRED OXYGEN
 • Low PATM Can decrease first part
- Differential Diagnosis ... obesity-hypoventilation syndrome ... embolus SHUNT ... hepatopulmonary syndrome ... #Differential #Diagnosis
Pulmonary Embolism on ECG 

Mid 30's female with chest pain/dyspnea.  Triage EKG (no prior).
Pulmonary Embolism ... Differential/diagnosis ... seen in 34% of cases ... #Embolism #ECG ... #clinical #cardiology
Shock Classification
Shock Definition: State of cellular and tissue hypoxia due to: reduced oxygen delivery, increased oxygen
embolism or severe ... pulmonary hypertension ... Classification #Types #diagnosis ... #management #cold ... warm #wet #dry #table
Shock - Differential Diagnosis by Classification
Reflex Syncope 
 - Vasovagal syncope
   • Prolonged standing
Shock - Differential ... Diagnosis by Classification ... Subclavian steal syndrome ... Classification #Table ... #Causes
Hyponatremia - Differential Diagnosis by Mechanism
Decr Blood Pressure (“Decr Effective Circulating Volume”) 
 - Volume depletion
- Differential Diagnosis ... - Cirrhosis Syndrome ... hemorrhage) - Pulmonary ... #Differential #Diagnosis ... #Table #Causes