The distinctive phenotypes of Acute Decompensated Heart Failure (ADHF), their presentations, and suggested therapeutic routes #Phenotypes #HeartFailure #Decompensated #CHF #Diagnosis #Management #Presentations

Treatment Algorithm for First Time Pulmonary Embolism • Provoked • Unprovoked • Active Malignancy By Carlin Rooke, MD. #PE #Pulmonary #Embolism #Treatment #Algorithm #management #hematology #VTE #thrombosis #venous

#protozoa #toxoplasma #leishmania #trypanosoma #babesia #malaria #plasmodium #cryptosporidium #cyclospora #cystisospora #entamoeba #acanthamoeba #microsporidia #ID #InfectiousDiseases #Infections #Microbiology #Micro #Differential #Ddx #Diagnosis By Dr. Sara Dong @swinndong via Febrile [febrilepodcast.com @febrilepodcast]

#rabies #rabiesprophylaxis #PEP #PrEP #rabiesvaccine #vaccine #rig #rabiesimmunoglobulin #immunoglobulin #ID #InfectiousDiseases #Infections By Dr. Sara Dong @swinndong via Febrile [febrilepodcast.com @febrilepodcast]

Effect of PEEP on Lung Recruitment - Bag-Mask Ventilation - Cadaver Simulation Simulation shows before and after adding 5cm H2O of PEEP. You can see the effect PEEP has on the lungs to maintain recruitment and ultimately prevent ventilation induced lung injury. Original video by Justin Krantz @JustinKrantzFPC #PEEP #Lungs #Cadaver #Simulation #clinical #video #Pulmonary #Positive #Pressure #BVM

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

Croup Diagnosis and Management Pearls Common childhood illness, usually viral and self limiting. Characterised by a seal-like "barking" cough. Accompanied by respiratory distress, stridor (due to subglottic narrowing), hoarse voice +/- fever. Often an URTI like prodrome (non-specific cough, rhinorrhea, and fever). Commonly affects children between 6 months and 6 years (peak age 2). Symptoms are usually worse at night. Symptoms usually resolve within 48 hours. Symptoms of impending respiratory failure include increasing upper airway obstruction, fatigue, sternal/intercostal recession, see-saw breathing, pallor or cyanosis, decreased level of consciousness. Evaluation: • Mild croup: Seal-like barking cough. No stridor or recession at rest. This can usually be managed at home → Patient advice leaflet. • Moderate croup: Seal-like barking cough with stridor and recession at rest. No agitation or lethargy. • Severe croup: Seal-like barking cough with stridor and recession associated with agitation or lethargy. BEWARE: The degree of chest wall recession may diminish as the child tires! Treatment: Single dose of oral dexamethasone - 0.15 mg/kg body weight PeterboroughEM @PeterboroughEM #Croup #Diagnosis #Management #pediatrics #peds

TiTrATE schema to approach to Dizziness • Time Course: Continuous or Episodic • Triggers: Present or absent? What are they? • A Targeted Exam: HINTS, Dix-Hallpike, additional history "Dizziness" a common yet imprecise symptom: • Vestibular (vertigo) • Cardiovascular (presyncope) • Neurological (disequilibrium) • Nonspecific (psychiatric, metabolic) Dr. Tyler Larsen @TylerLarsenMD #TiTrATE #Dizziness #dizzy #algorithm #differential #diagnosis #neurology

Effects of Strokes by Location - Anterior vs Posterior Localization Anterior Circulation - MCA - ACA - Lenticulostriate artery Posterior circulation - ASA - PICA - AICA - PCA - Basilar Artery #Strokes #Syndromes #CVA #Territory #Symptoms #Signs #Localization #Effects #Neurology #Diagnosis #Table #Territories ** GrepMed Recommended Text: Comprehensive Review in Clinical Neurology - https://amzn.to/2WxWZeP

Posterior cerebral artery (PCA) strokes can be challenging to diagnose, due to the variability in symptoms, which may be nonspecific and inconsistent upon initial presentation. The incidence of PCA strokes can be estimated between 5% to 10%. Patients may present in a comatose state via ambulance or may walk to an emergency department without assistance. Patients with a PCA stroke may present with only a headache and mild visual changes such as vision loss, diplopia, inability to see half of the view, or difficulty reading perceiving colors, or recognizing familiar faces. Satyendra Dhar MD, @DharSaty #PCAstroke #cva #stroke #antinsyndrome #hemianopia #alexia #agnosia #prosopagnosia #achromatopsia