Creatine Kinase - Causes of Elevated CK Levels Acute CK Elevation (Pain > Weakness): • RHABDOMYOLYSIS - Drugs: cocaine, amphetamines, alcohol - Medications: statins, fibrates, colchicine, daptomycin - Illness: viral (COVID19, CMV/EBV, HIV), clostridial spp, mycoplasma, staph, strep) - Seizures: Trauma, burns, hyperthermia, immobility • Critical Illness Myopathy (ICU, steroids, mechanical ventilation) • Myocardial infarction, Acute renal injury, Strenuous exercise Subacute to Chronic Causes (Weakness > Pain): • PROXIMAL MUSCLE WEAKNESS - Endocrine: Hypo/hyperthyroidism, acromegaly - Electrolytes: hypo- phos, kalemia, calcemia, natremia - Muscular dystrophy - Metabolic Myopathies - Neuromuscular disorders - Vit D/E deficiency - Medications- Statins, fibrates, colchicine, daptomycin - Chronic Illness: HIV, Trichinella, toxoplasmosis - Inflammatory myopathy: dermatomyositis, polymyositis, necrotizing myopathy - Autoimmune: mixed connective tissue disorder, SLE • PROXIMAL AND DISTA: Inclusion body myositis • ASYMPTOMATIC: Macro CK Ann Marie Kumfer @AnnKumfer #Creatine #Kinase #Elevated #CK #differential #diagnosis #rhabdomyolysis

Heart Murmurs - Classification - Adults Dr. André Mansoor @AndreMansoor - Frameworks for Internal Medicine https://amzn.to/2LmUODZ #Heart #Murmurs #Systolic #Diastolic #Classification #Adult #Cardiology #Differential #Diagnosis

#melioidosis

#Melioidosis #Burkholderia pseudomallei

Myositis Specific Antibodies (MSAs) Dermatomyositis: MDA5, TIF1y, NXP2, Mi-2, SAE Anti-Synthetase Syndrome: Jo-1, PL7, PL12, EJ, OJ Immune Mediated Necrotizing Myopathy (IMNM): HMGCR, SRP Inclusion Body Myositis (IBM) + others: NT5c1A/cN1A By Mithu Maheswaranathan, MD @MithuRheum #Myositis #Specific #Antibodies #MSAs #clinical #diagnosis #rheumatology #table

Hypereosinophilia and Hypereosinophilic Syndrome • Secondary Hypereosinophilic Syndrome • Clinically Relevant HES Variants • When to suspect underlying hematologic disorders • Diagnosis and Treatment Algorithm Matthew Ho, MD PhD @MatthewHoMD #Hypereosinophilia #Hypereosinophilic #Syndrome #HES #Hematology #eosinophilia #eosinophils #diagnosis #management #algorithm

Oxygen Therapy Devices • Nasal Cannula • High Flow Nasal Cannula • Facemask / Non-rebreather • Heated High-Flow • Non-Invasive Positive Pressure Ventilation • Intubation #Oxygen #Devices #Management #Respiratory #Therapy

Hypokalemia - Differential Diagnosis Algorithm Extra-renal Losses: • Normal Acid-Base: Low intake • Metabolic acidosis: Gl tract loss (Diarrhea) Renal Losses: • Metabolic acidosis: Proximal and distal RTA, Ureterosigmoidoscopy • HTN, Low Aldosterone: Liddle's Syndrome, Licorice, Carbenoxolone, SAME, Cushing Syndrome • HTN, High Aldosterone: Malignant HTN, Renovascular HTN, Renin secreting tumor, Primary hyperaldosteronism • HTN Absent: Loop and thiazide diuretics, Bartter syndrome, Gitelman syndrom, Vomiting, Non-reabsorbable anions Dr Priti Meena @priti899 #Hypokalemia #Differential #Diagnosis #Algorithm #causes #potassium #low #nephrology

CMV vs EBV - Mononucleosis Acute CMV Infection: • Asymptomatic (most common) • Infectious mononucleosis (fever/chills, malaise) • Fever: More protracted • Cervical Lymphadenopathy: Less common (< 20%) • Generalized Lymphadenopathy: Less common • Exudative Tonsillopharyngitis: Rare • Splenomegaly: Less common EBV • Fever: Common • Cervical Lymphadenopathy: Common • Generalized Lymphadenopathy: Common (> 80%) • Exudative Tonsillopharyngitis: Common • Splenomegaly: More Common BWH Medicine Chiefs @BrighamChiefs #CMV #EBV #Mononucleosis #diagnosis #comparison #infectious

Cytomegalovirus (CMV) in HIV-AIDS Patients Cytomegalovirus (CMV): double-stranded DNA virus, herpesvirus family. CMV infection: virus isolation or detection in any body fluid or tissue specimen regardless of symptoms or signs. Diagnosis: Quantitative PCR and CMV pp65 antigenemia test. For tissue-invasive CMV CMV, inclusions or positive specific immunohistochemistry on histopathology. Suspect these CMV-related conditions in any patient with HIV and CD4 50 or less: • Neurologic: Encephalitis, Myelitis, Polyradiculopathy, Peripheral Neuropathy • Eye: Retinitis (Most common cause of blindness in AIDS) • Liver: Hepatitis, Portal vein thrombosis • Endocrine: Infectious Adrenalitis, Pancreatitis • Pulmonary: Pneumonitis (In association with PJP/TB) • Cardiovascular: Myocarditis, ↑Cardiovascular risk, DVT • Gastrointestinal: Esophagitis, Enteritis, Colitis By @TheIDtrivia #Cytomegalovirus #CMV #HIV #AIDS #diagnosis #differential #signs #symptoms