Algorithm for Evaluation for ACS In Patients with Chest Pain In The Emergency Department https://bit.ly/chestpainalgorithm #ACS #ChestPain #algorithm #emergency #cardiology #acute #coronary #syndrome

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 - Daily Rounding and Disposition Checklist Daily Checklist: • FEN/GI: Indications for NPO [ ] Upcoming procedure [ ] PET scan (also avoid dextrose-containing fluids – review all IV meds) [ ] Concern for aspiration of all PO intake (including medications) [ ] Avoid caffeine prior to regadenoson stress testinga [ ] IV fluids (always put end-time/total amount and review daily) • DVT prophylaxis [ ] SCDs [ ] Enoxaparin subQ if CrCl >30 (hold 24 hours before most procedures) [ ] Heparin subQ if CrCl <30 (hold 6 hours before most procedures) [ ] Contraindications: active bleeding, low platelet count, upcoming procedures • Stress ulcer prophylaxis Indications (for critically ill patients) [ ] On mechanical ventilator for >48 hours [ ] Coagulopathy (INR >1.5, plt <50) [ ] High-dose/chronic steroid or NSAID use [ ] Recent GI bleed • Code status - Options include: Full, DNR/never intubate, DNR/okay to intubate, compressions okay/never intubate Disposition Checklist: [ ] Update family/DPOA on status of patient [ ] Fill out/update POLST form (if indicated) [ ] Post-hospitalization living situation [ ] Insurance for meds (prior authorization) and nursing homes [ ] Post-discharge transportation [ ] Equipment at home for safety/function [ ] Outpatient referrals and appointments [ ] Consider need for prescriptions (new medications, refills) [ ] Discharge medication education [ ] Discharge summary (include pending inpatient labs that require outpatient follow-up) [ ] Outpatient labs if needed [ ] Handoff communication to accepting provider (PCP, SNFist, etc.) Dr. Satya Patel @SatyaPatelMD Full Inpatient Pocket Cards Collection: https://bit.ly/pocketcardset #Daily #Rounding #Disposition #Checklist #management #inpatient #internship

Intern Pocket Cards - Inpatient Bowel Regimen Guide Osmotic agents (draws water into bowel, thereby loosening stool and promoting evacuation): • Polyethylene glycol - Nausea, bloating, cramping • Lactulose, Sorbitol - Abdominal bloating, flatulence • Glycerin - Rectal irritation • Magnesium sulfate PO, Magnesium citrate - Watery stools and urgency Stimulant laxatives: • Bisacodyl - Rectal irritation • Senna - Melanosis coli Bulk-forming laxatives (fiber absorbs excess water and stimulates elimination): • Psyllium - Impaction above strictures, fluid overload, gas, and bloating Rectal distension: • Tap water enema - Discomfort during procedure Notice that docusate is not on here as it is a #TWDFNR Dr. Satya Patel @SatyaPatelMD Full Inpatient Pocket Cards Collection: https://bit.ly/pocketcardset #Bowel #Regimen #Guide #Inpatient #medications #constipation #pharmacology #table #agents #internship #comparison

Approach to the Hospitalized Patient with Cirrhosis 1) Recognize and Manage Decompensation • Ascites • Variceal Bleeding • Hepatic Encephalopathy 2) Manage Common Scenarios • Alcoholic Hepatitis • Hepatorenal Syndrome • Prognostication 3) Know your advanced therapies • Transjugular Intrahepatic Portosystemic Shunt • Liver transplant Dean Ehrlich MD @DeanEhrlich_MD #inpatient #Cirrhosis #diagnosis #treatment #management

Diabetes Mellitus Type 2 Inpatient Medication Guide Classes: Biguanide, Sulfonylurea, TZD, DPP-4 inhibitor, GLP-1 receptor agonist, SGLT2i, Meglitinide, α-glucosidase inhibitor Inpatient blood glucose goal 140-180 mg/dL Insulin Pearls: • Calculate total daily dose of insulin and adjust appropriately • Weight-based insulin 0.3-0.6 units/kg/day ~50% basal + ~50% mealtime • If NPO, stop mealtime insulin and reduce basal insulin by ~20% • Never completely discontinue basal insulin in Type 1 Diabetes Mellitus • Assess for presence of insulin pumps and continuous glucose monitors in Type 1 Diabetes Mellitus • If sliding scale insulin requirements are minimal, consider discontinuing it completely • Adjust insulin dose for renal dysfunction and older age Dr. Satya Patel @SatyaPatelMD Full Inpatient Pocket Cards Collection: https://bit.ly/pocketcardset #Diabetes #Mellitus #DM2 #Inpatient #Medications #pharmacology #comparison #table #endocrinology

Antibiotic Considerations for the Medical Resident - Reference Cheatsheet Dr. Jesse Burk-Rafel @jbrafel #Antibiotics #Management #Cheatsheet #Pharmacology #Guide #Inpatient #Empiric

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

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

Inpatient Pnuemonia Management Algorithm - IDSA 2019 Guidelines Carla Canepa MD https://www.instagram.com/_carlemd_ #Pneumonia #Management #Algorithm #IDSA2019 #Guidelines #Inpatient #HAP #HCAP #Treatment #Severity #Criteria