Eduardo sanchez @TeamMuni on GrepMed

COVID-19 Diagnosis and Management Summary Clinical and laboratory testing Lung Ultrasound HRCT scan In-hospital treatment Severity assessment and respiratory support Post-mortem studies Long-term follow-up - Dr. Giuseppe Sfuncia @Revivan75 #COVID19 #Diagnosis #Management #Summary #treatment

R Wave Progression - normal chest lead ECG shows an rS-type complex in lead V1 with a steady increase in the relative size of the R-wave toward the left chest and a decrease in the S wave amplitude. #Diagnosis #Cardiology #MedStudent #EKG #RWave #Progression #PRWP #ECGEducator

What are the original Sgarbossa Criteria? - Concordant ST-segment elevation ≥ 1 mm in any lead = 5 points - Concordant ST-segment depression ≥ 1 mm in lead V1 – V3 = 3 points - Discordant ST-segment elevation ≥ 5 mm in any lead = 2 points #Diagnosis #Cardiology #Original #Sgarbossa #Criteria #LBBB #RebelEM

High Anion Gap Metabolic Acidosis (HAGMA) - Mnemonics Why should we switch from MUDPILES to GOLDMARK? • Metabolic acidosis due to excessive paraldehyde or phenformin use has become very rare. • Iron and isoniazid are just two of many drugs and toxins that can cause hypotension and lactic acidosis. Isoniazid can also generate a component of ketoacidosis. • Three new organic acids and acid precursors have been recognized as causes of AGMA: 1) D-lactate, 2) 5-oxoproline, 3) propylene glycol #AnionGap #Metabolic #Acidosis #HAGMA #Mnemonic #GOLDMARK

Magic Mouthwash Ingredients for Mucositis Magic Mouthwash Recipe 1 (Disp: 480 ml) • 80 ml viscous lidocaine 2% • 80 ml Mylanta • 80 ml diphenhydramine 12.5 mg per 5 ml elixir • 80 ml nystatin 100,000U suspension • 80 ml prednisolone 15mg per 5ml solution • 80 ml distilled water Magic Mouthwash Recipe 2 (Quantity: 120ml) • 1 Part viscous lidocaine 2% • 1 Part Maalox (do not substitute Kaopectate) • 1 Part diphenhydramine 12.5 mg per 5 ml elixir #Magic #Mouthwash #Ingredients #Mucositis #pharmacology #compounding #recipes #cocktail

Heart Failure (HFrEF) Treatment - GDMT for stage C For patients with Heart Failure with REDUCED Ejection Fraction (HFrEF), we follow Guideline-Directed Medical Therapy (GDMT). GDMT is basically getting patients on medication regimens that have been evidenced to have a mortality benefit, while also considering adding other agents for morbidity benefits when appropriate. In patients with HFrEF, we should initiate them on ACEI or ARB and an evidenced beta-blocker since these have mortality benefits. It's important to have both of these medications on board, then titrate them up to the target dose (as tolerated). If patients have edema then add on loop diuretics. After a patient is on maximally tolerated ACEI/ARB + Beta-Blocker, we can move to the next section of possible agents. Agents with mortality benefit in second-line include Entresto (replacing ACEI/ARB), spironolactone, and BiDil (for African American patients). Additionally we can consider adding ivabradine if patients HR is still >70 despite the beta blocker. This process is recommended by the ACC/AHA guidelines. We may also consider digoxin for morbidity benefits in certain situations as well. Jarred Prudencio, PharmD - https://www.instagram.com/ambcarerx #CHF #sCHF #HeartFailure #HFrEF #Pharmacology #Management #Treatment #StageC #Cardiology

Wellens Syndrome on EKG Associated with a critical stenosis of the proximal LAD, suggestive of impending infarction - Present in pain-free state with history of recent angina - Abnormal T-wave in V2 & V3 - Isoelectric ST segment Type A: Biphasic Terminal T-wave Inversion Type B: Deep Symmetric T-wave Inversion FOAMfrat Team @FOAMfrat #Wellens #Syndrome #EKG #ecg #cardiology #electrocardiogram #diagnosis

Refeeding Syndrome: Pathogenesis and clinical findings Patients at Risk of Refeeding Syndrome: - Little or no nutritional intake in recent past - Significant weight loss - Low BMI < 18.5 kg/m2 - Electrolyte disturbances: low K, PO4& Mg prior to feeding - History of alcohol abuse or drugs including diuretics, insulin, chemotherapy and or antacids RAPID REFEEDING -> -> Incr glucose, fluid, salt and nutrients from any source; oral, enteral or parenteral -> Insulin secretion • Incr Na retention -> Fluid overload -> - CHF - Pulmonary Edema - Cardiac Arrhythmias / Death • Incr Glucose Metabolism -> Decr Thiamine - Wernicke-Korsakoff Syndrome - Metabolic Acidosis • Shift of K, PO4 and Mg into cells -> Decr Serum K, Mg, Ca -> Changes in action potential threshold - Tetany - Cardiac Arrhythmias / Death • Incr synthesis of proteins -> decr Serum PO4 -> decr RBC ATP + 2,3-DPG -> - hemolysis - anemia - CNS: Tremors, Ataxia, Coma, Delirium - GI: Anorexia, Constipation - MSK: Weakness #Refeeding #Syndrome #diagnosis #pathophysiology #symptoms #signs

ECG Interpretation Basics Quick Reference - Rhythm and Rate - QRS / Blocks - Intervals - Axis - Chambers - ST/T/Q (Ischemia) By Dr. Zaven Sargsyan @sargsyanz #ECG #Interpretation #Basics #EKG #Electrocardiogram #Cardiology #Diagnosis #cheatsheet

Lithium Treatment Guidelines - Rosen's, Tintinalli's, Goldfrank and Extrip 2015 #Management #Lithium #Toxicology #Treatment