Patterns of Diseases on MRI FLAIR - Differential Diagnosis ADEM, Adreno-leukodystrophy, CADASIL, CNS, Lymphoma, High-Grade Glioma, HIV Encephalopathy, Low-Grade Glioma, Metastases, Migraine, MS: Active, MS: Inactive, MS: Tumefactive, NMO, PRES, PML, Small Vessel Ischemic Disease, Susac Syndrome, Toxic Leukoencephalopathy, Vascular Ischemia #FLAIR #Patterns #Diseases #MRI #Differential #Diagnosis #neuroradiology #clinical

Correction formulas for Hypernatremia and Hyponatremia #Management #Nephro #Hyponatremia #Hypernatremia #Correction #FreeWaterDeficit #Formulas #Androgue #Calculation

#Table 3 summarizes common types of neuropathies that should be considered according to their characteristic patterns of neurologic findings.

An Algorithm for the Diagnosis of Wheezing and Stridor Stridor: Louder, constant-pitch sound over central airways Wheezing: Musical sound produced primarily during expiration Inspiratory Stridor (Supraglottic): • Extraluminal Compression: Goiter, Retropharyngeal abscess • Intraluminal Compression: Malignancy, Foreign body • Inflammatory: Anaphylaxis, Angioedema, Epiglottitis Biphasic Stridor (Glottic/Subglottic): • Functional: Vocal fold paralysis, Paradoxical vocal fold motion • Extraluminal Compression: Malignancy, Vascular ring, aneurysm • Intraluminal Compression: Foreign body • Stenosis: Iatrogenic, Endotracheal intubation Expiratory (Tracheal) Stridor: • Extraluminal Compression: Malignancy, Mediastinal mass, Vascular ring, aneurysm • intraluminal Compression: Foreign body • Stenosis - Iatrogenic: Endotracheal intubation, Tracheostomy - Structural weakness: Tracheomalacia, Connective tissue disorder, GERD - Autoimmune: GPA Lower Airway Wheezing (Intrathoracic): • Bronchoconstriction: Asthma, COPD, Anaphylaxis, Carcinoid • Compression: Extraluminal - Peribronchial pulmonary edema • Infectious: Bronchitis, Bronchiolitis, Parasite • Focal: Mass, Foreign body, Consolidation (Infection, Infarction) #Wheezing #Stridor #Noisy #Breathing #differential #diagnosis #algorithm #pulmonary

Diabetes Type 2 Medication Management and Titration Algorithm - First line therapy is metformin and comprehensive lifestyle changes - Established ASCVD or CKD - Without established ASCVD or CKD #Diabetes #DM2 #Type2 #Medication #Management #Algorithm #endocrinology #DMII

Alcohol Withdrawal Management Algorithm Mild vs Moderate/Severe #Management #Alcohol #Withdrawal #EtOH #Protocol #Algorithm #Phenobarbital #Diazepam #Valium

Phenobarbital monotherapy algorithm for alcohol withdrawal ** EDIT - SEE UPDATED ALGORITHM HERE: https://www.grepmed.com/images/4060/phenobarbital-monotherapy-withdrawal-management-algorithm-protocol-pulmcrit -Phenobarbital monotherapy has numerous advantages compared to benzodiazepines. Emerging evidence suggests that translates into meaningful clinical benefit. -If 15 mg/kg phenobarbital fails to achieve clinical resolution, this suggests that the patient may have another problem in addition to alcohol withdrawal. Alternative causes of delirium should be explored. -For severely agitated patients, dexmedetomidine can be useful initially to gain behavioral control. However, phenobarbital should be rapidly up-titrated to treat the underlying disorder and avoid seizure. -An updated approach to phenobarbital use is suggested (figure below). -If you work at a center that is using lorazepam for alcohol withdrawal, the current shortage of lorazepam isn't a threat – it's an opportunity to move to a superior therapy. #Management #Alcohol #EtOH #Withdrawal #Phenobarbital #Monotherapy #Algorithm #Protocol #PulmCrit

Post-Exposure Prophylaxis (PEP) Monitoring • Initial / ED Visit: HIV Ab/Ag, Hep B serologies, HCV Ab, ALT/AST, BUN/Cr, GC/CT, Treponemal Ab, Pregnancy test • 4-5 weeks: HIV Ab/Ag, ALT/AST, BUN/Cr, GC/CT, Treponemal Ab, Pregnancy test • 3 months: HIV Ab/Ag • 6 months: HIV Ab/Ag, Hep B serologies, HCV Ab - BIDMC Infectious Diseases Fellowship @BIDMC_IDFellows #PostExposure #Prophylaxis #PEP #Monitoring #diagnosis #laboratory #timeline #hiv

Management Algorithm for Status Epilepticus • Assess airway, breathing, and circulation • Pulse oximetry • Electrocardiogram • Finger stick (give IV dextrose if glucose < 60 mg/dL) • Aspiration precautions (lateral decubitus) First-line therapy: o Diazepam 5 mg up to a max of 20 mg o Lorazepam 2 mg up to a max of 10 mg o Midazolam 10 mg IV/lM/intranasal Second-line therapy: • Phenytoin 20 mg/kg IV at a maximum rate of 50 mg/min (may give additional 5-10 mg/kg) or • Fosphenytoin 20 PE/kg IM or IV at 150 mg/min (can give additional 5 PE/kg) or • Valproic acid 20-40 mg/kg at 3-6 mg/kg/min or • Levetiracetam 1000-3000 mg over 15 min Third-line therapy: • Intubation and electroencephalogram recommended • Pentobarbital 5 mg/kg IV at 1-5 mg/kg/hr, then 0.5-3.0-mg/kg/hr infusion as needed or • Phenobarbital 20 mg/kg IV at 50-75 mg/min or • Midazolam 0.2 mg/kg IV, then 0.1-0.4 mg/kg/hr or • Propofol 2 mg/kg IV at 2-5 mg/kg/hr, then 5-10 mg/kg/hr as needed #StatusEpilepticus #Management #Algorithm #Neurology #pharmacology #dosing #seizure

Radiographic Features of Pulmonary Diseases - Pneumonia - Atelectasis - Emphysema - Pneumothorax - Effusion - Carcinoma - Metastases - Interstitial - Nodular - Acute Interstitial - Ground Glass Opacity - Chronic Interstitial - Reticular - Emphysema - Pulmonary Embolism - Acute Pulmonary Edema - Congestive Cardiac Failure #Pulmonary #Diseases #Radiology #Patterns #Lung #CXR #XRay #ChestCT #Differential #Diagnosis