Monthly Archives: August 2017
Choledocholithiasis – 08/23/2017
Digoxin Toxicity – 08/21/2017
Candida Pyelonephritis – 8/28/17
- Risk factors for systemic candida include immunosuppression, intravascular catheters (TPN), broad spectrum antibiotics
- Infection is considered systemic once you have positive blood cultures
- Once you are concerned for systemic infection, make sure to get an Ophthalmology consult to rule out endophthalmitis!
- Start with an echinocandin for treatment unless you have a UTI, meningitis, or endophthalmitis in which cause you should use an azole medication
- If you have evidence of Candida glabrata then an azole may not work because there tends to be resistance
- If you have Candida glabrata meningitis, UTI, or endophthalmitis, you should start with amphotericin until you have susceptibilities
- Do not treat asymptomatic candiduria unless the patient is neutropenic or had recent urologic procedures done
Brugada Syndrome 8/23/17
New Onset Afib – 08/15/2017
Asthma Exacerbation – 08/10/2017
Upper GI Bleed 08/08/2017
- Upper GI Bleed = Proximal to ligament of Treitz (suspensory muscle that holds the duodenum)
- Lower GI Bleed = Distal to ligament of Treitz
- Factors most predictive of an upper GI source
- Hx of Melena
- Hematochezia is usually due to lower GI Bleed, But it can still occur with massive upper GI bleeding!
- Coffee ground emesis
- Ratio BUN:Cr >30
- Hx of Melena
Clostridium Difficile – 07/31/2017
Status Epilepticus – 08/02/2017
- Do we use Keppra (Levetiracetam) for GCSE?
- Generally No -> Not FDA approved for status epilepticus.
- Keppra has weak evidence to support it in the treatment of status
- More useful in suppressing subsequent seizures after GCSE is controlled
- Generally No -> Not FDA approved for status epilepticus.
SCVMC IM Chief Resident Blog 