MonkeyPox Virus - Summary Review - What we know so far • History • Epidemiology • Signs and Symptoms • Transmission • Differential Diagnosis • Diagnosis • Treatment By Dr. Brenda Anosike and Dr. Margaret Aldrich via @id_peds #Monkeypox #diagnosis #management #virus #infectiousdiseases #microbiology #treatment

Rounding checklist for COVID19 patients Rounding checklist for my COVID19 patients so we don't miss stuff. It is also a time for us to deliberate on how to cluster activities and ensure we don't miss what is the most important at all time: Keeping our human connection with them! Thoughts / suggestion welcome! Viren Kaul, MD @virenkaul #Rounding #Checklist #Daily #COVID19 #Diagnosis #Management #SARSCoV2 #Coronavirus

#blood supply of the brain

Hepatobiliary Manifestations of Sickle Cell Disease Acute sickle cell hepatic crisis: • Fever, acute onset RUQ pain, jaundice and tender hepatomegaly • Supportive with treatment of SCD crisis Acute Hepatic sequestration: • Acute onset RUQ pain, hepatomegaly and anemia • Supportive with blood or exchange transfusion Acute intrahepatic cholestasis: • Fever, RUQ pain rapidly progressing to acute liver failure • Supportive, exchange transfusion, correction of coagulopathy? Liver transplant BWH Medicine Chiefs @BrighamChiefs #SickleCell #Disease #Hepatobiliary #hepatology #hepatitis #differential #diagnosis

MGH Sedation protocol for mechanically ventilated COVID-19 patients #Sedation #Analgesia #Protocol #COVID19 #CriticalCare #Treatment #MGH #Management #Coronavirus #SARSCOV2

Oxygen Delivery Systems Nasal Cannula: • Flow: 1 - 6 L/min • FiO2: 25 - 40% (-4%/L of flow) Face Mask: • Flow: 5 - 10 L/min • FiO2: 40 - 60% Device: Face Tent • Flow: 10 - 15 L/min • FiO2: ~40% Venturi Mask: • Flow: 2 - 15 L/min (based on valve) • FiO2: 24 - 60% (precisely controlled) Non-Rebreather: • Flow: 10 - 15 Lmin • FiO2: 80 - 95% High Flow Nasal Cannula: • Flow: up to 60 L/min • FiO2: 21 - 100% - Dr. Rishi Kumar @rishikumarmd #Oxygen #Delivery #Systems #respiratory #support #devices #management #pulmonary #comparison

Menstrual Cycle Physiology: Ovarian Cycle – Follicular Phase Explained Early Follicular Phase (Days 0-5) • Granulosa cells secrete activin, a hormone that 1) Incr FSH production by pituitary, 2) Incr FSH receptors on granulosa cells, and 3) Decr theca cell androgen production. • This effect limits conversion to estrogen, preventing estrogen from negatively feeding back on anterior pituitary which would reduce FSH production. • Resulting high FSH level stimulates follicle growth. • By Day 5, the dominant follicle (the one most responsive to FSH) will be selected to continue growing (mechanism for this "selection" unclear, but this follicle is also the first to switch from activin to inhibin, and that inhibin decr the FSH such that other follicles are not as stimulated). Late Follicular Phase (Days 5-14) • Granulosa cells of dominant follicle switch to secreting inhibin instead of activin. Inhibin 1) Decr FSH production by pituitary, and 2) helps LH Incr theca cell production of androgens (leading to Incr conversion to estrogen) • The Incr in estrogen during this time: 1. Incr FSH receptors on the follicle 2. Negatively feeds back on pituitary to reduce, not stop, FSH production (dominant follicle still grows because of greater number of FSH receptors) 3. Incr number of LH receptors on granulosa cells of the follicle, preparing for ovulation Note: 1) Inhibin and activin are named for their effect on the anterior pituitary's FSH production. 2) Timely balance in steroid secretion between theca and granulosa cells is key to normal follicle growth. Disruption of this balance can lead to menstrual cycle disorders. I.e. early estrogen secretion -> inhibits FSH secretion too early -> lack of follicle growth (this is one mechanism behind Polycystic Ovarian Syndrome, PCOS). #MenstrualCycle #OvarianCycle #pathophysiology #FollicularPhase #endocrinology

De Winter T Wave ECG Pattern STEMI Equivalent - Left anterior descending (LAD) occlusion 1) Upsloping ST elevation in aVR (>= 1 mm) 2) ST depressions and tall T waves in precordial leads #DeWinter #TWaves #ECG #EKG #Electrocardiogram #Diagnosis #Cardiology #Criteria

Antibiotic Classification by Mechanism of Action Cell Wall Synthesis: Penicillins Cephalosporins Carbapenems Monobactams Beta-lactamase inhibitors Glycopeptides Protein Synthesis: Aminoglycosides Tetracyclines Oxazolidonones Streptogramins Cloramphenicol Macrolides Lincosamides DNA Topoisomerases: Fluorquinolones Quinolones Folic Acid Synthesis: Sulfonamides DHFR inhibitors DNA Damage: Metronidazole mRNA Synthesis: Rifampin #Antibiotic #Classification #Pharmacology #Mechanism #Action #Family ** GrepMed Recommended Text: Clinical Pharmacology Made Ridiculously Simple - https://amzn.to/3cuD1am

Boerhaave Syndrome Postemesis Iatrogenic (most common) Left Posterolateral most common Mackler's Triad: Lower Chest Pain Vomiting Subcutaneous Emphysema #Boerhaave #Syndrome #Diagnosis #Signs