What is the narrative that you hear when faced with uncertainty?
The first week of my big attending job, I saw a patient with fever, sore throat, no cough, and tonsillar exudates. Well-trained to manage septic shock, but having no idea how to practice in a primary care clinic, I crafted a vast array of infectious and inflammatory diagnoses. With a quick glance, my senior partner
Read more…
What is the narrative that you hear when faced with uncertainty? originally appeared in KevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - July 15, 2022 Category: General Medicine Authors: Kara Pepper, MD Tags: Physician Hospital-Based Medicine Primary Care Source Type: blogs
Get ready for a COVID culture shock
A friend called me for medical advice two weeks ago. He’s single, in his 30s and generally healthy, but he’d developed a dry cough with mild congestion. After a self-administered COVID-19 test turned up negative results, he remained suspicious he could be infected. He was set to fly west in a couple of days forRead more …Get ready for a COVID culture shock originally appeared inKevinMD.com. (Source: Kevin, M.D. - Medical Weblog)
Source: Kevin, M.D. - Medical Weblog - June 27, 2022 Category: General Medicine Authors: < span itemprop="author" > < a href="https://www.kevinmd.com/post-author/robert-pearl" rel="tag" data-wpel-link="internal" > Robert Pearl, MD < /a > < /span > Tags: Physician COVID Infectious Disease Source Type: blogs
A man in his 30s with chest pain and a normal bedside echo, without wall motion abnormality
In conclusion — our THANKS to Drs. Nicacio and Meyers for presenting today ' s case. As interesting as I found the initial ECG to be — the KEY point in today ' s case is that identification of suspicious (albeit indefinite) ECG findings in this patient with typical unrelieved chest pain merited timely cath (which was done within 15 minutes of ED presentation) — and this confirmed the need for prompt revascularization. (Source: Dr. Smith's ECG Blog)
Source: Dr. Smith's ECG Blog - June 17, 2022 Category: Cardiology Authors: Pendell Source Type: blogs
Medical report
So, I had a breakthrough Covid infection, which really frosts my pumpkin because I ' ve had four shots, the most recent less than a month ago. Presumably I was exposed on the trip somehow. I was particularly miserable because the first symptom I got was myalgia in my right pectoral, which means it hurts ever time I cough. Not so much today, I ' m feeling better, and the worst of it only lasted about 36 hours, so believe me, vaccination is worth it. But it won ' t prevent infection entirely.That mean I was in no condition to post yesterday, so I ' ll try to make it up with another later today. In the meantime, take it from ...
Source: Stayin' Alive - June 11, 2022 Category: American Health Source Type: blogs
Is this Myo-pericarditis? Or OMI with subsequent pericarditis? Does the angiogram always explain the ECG findings?
Conclusion: Although at 1st glance, it looked like the ECG picture in Figure-1 might be suggestive of acute pericarditis — on further inspection, there are significant ECG features against the diagnosis of acute uncomplicated pericarditis.As per the superb discussion above by Dr. Smith — evolution of this case (including the ECG picture on serial tracings) — are consistent with what probably occurred in today ' s case, namely the combination of acute OMI from LCx occlusion, followed by development of post-infarction regional per...
Source: Dr. Smith's ECG Blog - June 11, 2022 Category: Cardiology Authors: Steve Smith Source Type: blogs
Stigmatisation of yawning could be a strategy to avoid disease, study argues
By Matthew Warren
It’s really common to start yawning after seeing someone else do it. You might even be yawning right now, just reading about it. But we also instinctively know that there’s something a bit rude about yawning: we’re less likely to show this “yawn contagion” when we’re being watched, for instance. And even when we do yawn in the presence of others, we’ll often cover our mouth.
Why does yawning carry this stigma? The obvious explanation is that yawning indicates that we are tired or bored, and we might not want to make others feel like they are the source of that boredom (even if they ...
Source: BPS RESEARCH DIGEST - May 26, 2022 Category: Psychiatry & Psychology Authors: BPS Research Digest Tags: Cognition Health Source Type: blogs
Does a Single Troponin below the 99th percentile URL Rule out Acute MI if the Chest pain is very prolonged?
A 66 y.o. male who presented for chest pain that started this AM when he woke up, and has persisted throughout the day prompting him to call 911. He says the pain is dull in nature and located across the chest, does not radiate, that it isworse with exhalation. He denies worsening with activity or positioning. He endorses SOB and requested to sit up. He says this has not happened to him before. He endorses cough productive of yellow sputum. He denies any edema. Denies history of venous thromboembolism. He endorses a 50 pack year history of smoking. He denies recent illness or recent s...
Source: Dr. Smith's ECG Blog - May 26, 2022 Category: Cardiology Authors: Steve Smith Source Type: blogs
Case of the Week 683
Answer to Case 683:Cryptosporidiumsp. oocystsThe following OUTSTANDING discussion is from our guest author, Hadel Go, a third year medical student with a strong interest in clinical parasitology._________________________________________We received some excellent feedback! Thank you all for leaving comments on the blog, on Twitter, and on LinkedIn.Yes, these areCryptosporidium oocysts. These protozoans can be identified by their size and consistent red color on modified acid-fast staining of stool samples. They can also be diagnosed from H&E stained tissue biopsies (see images here:Cryptosporidium, parasitewonders.com),...
Source: Creepy Dreadful Wonderful Parasites - May 22, 2022 Category: Parasitology Source Type: blogs
Chest pain, shortness of breath, T wave inversion, and rising troponin in a young healthy runner.
In this study, 40 presumably healthy male marathon runners had their cardiac troponin and other findings measured before and after running a marathon. 39 pts (97.5%) had baseline cTnT values below the reference limit (less than 14 ng/L). 38 pts (95%) of participants had post-marathon cTnT concentration rise above this reference limit. The median post-marathon cTnT was 41 ng/L, and the 95th percentile concentration was 90 ng/L. None reported " cardiac symptoms " after the race.See this single post for many examples of BTWI:Understanding this pathognomonic ECG would have greatly benefitted the patient.More cases involving BT...
Source: Dr. Smith's ECG Blog - May 19, 2022 Category: Cardiology Authors: Pendell Source Type: blogs
---
Answer to theParasite Case of the Week 682:Schistosoma mansoniegg.The following post is from our first ever guest author, Hadel Go. I think you will all agree that Hadel did an outstanding job writing up the answer to the case of the week, and that this is truly one of the best case answers we have had on this blog.__________________________________Hadel Go, Medical Student, Guest AuthorThis is aSchistosoma mansoniegg in lung tissue as many of you correctly identified in the comments. The large lateral spine is a dead giveaway and creates the “quote bubble” morphology mentioned by Jacob @eternalstudying on Twitte...
Source: Creepy Dreadful Wonderful Parasites - May 17, 2022 Category: Parasitology Source Type: blogs
Answer to Case 682
Answer to theParasite Case of the Week 682:Schistosoma mansoniegg.The following post is from our first ever guest author, Hadel Go. I think you will all agree that Hadel did an outstanding job writing up the answer to the case of the week, and that this is truly one of the best case answers we have had on this blog.__________________________________Hadel Go, Medical Student, Guest AuthorThis is aSchistosoma mansoniegg in lung tissue as many of you correctly identified in the comments. The large lateral spine is a dead giveaway and creates the “quote bubble” morphology mentioned by Jacob @eternalstudying on Twitte...
Source: Creepy Dreadful Wonderful Parasites - May 17, 2022 Category: Parasitology Source Type: blogs
A man in his 40s who really needs you to understand his ECG
Written by Pendell MeyersA man in his 40s presented for " left sided chest pain sudden onset yesterday when sneezing and coughing that is worsened with inspiration. " He also complained of associated SOB, dizziness, jaw pain, and back pain, which he described as " muscle spasms. " He has also had rhinorrhea and cough for 1 week. Also, left hand numbness today. He went to urgent care for evaluation. An ECG was performed there (unavailable) which reportedly was abnormal, so EMS was called to urgent care to take him to the ED.On EMS arrival, they noted the patient vomited then became unresponsive. He was reportedly...
Source: Dr. Smith's ECG Blog - May 1, 2022 Category: Cardiology Authors: Pendell Source Type: blogs
Lymphangioleiomyomatosis (LAM)- CT Findings
History :A 26 years female c/o dyspnoea and mild cough since 4 monthsFindings:The CT scan shows multiple thin walled cysts of varying sizes in both the lungs. The CP angle are involved. Perivascular in location. No zonal predominance. Findings are s/o LAMDiagnosis:Lymphangioleiomyomatosis (LAM)Extra EdgeExamples of Cystic Lung DiseaseLAMLCHLIPBHD (Birt hogg Dube)AmyloidosisLAMFemaleNo smokingNo zonal predominanceCP angles involvedLCHMaleSmokerUpper zone predominanceCP angles sparedFamous Radiology Blog by Dr Sumer Sethi www.sumersethi.com (Source: Sumer's Radiology Site)
Source: Sumer's Radiology Site - February 21, 2022 Category: Radiology Authors: Sumer Sethi Source Type: blogs
Wearable Air Sampler to Assess SARS-CoV-2 Exposure
Researchers at Yale University created a wearable air sampler clip that can be worn on clothing and which can bind aerosols present in the environment. The clip can later be analyzed to determine the level of SARS-CoV-2 exposure while it was worn. The low-cost, battery-free technology could allow people to identify unsafe indoor environments that may require additional safety measures. While the design does not allow for real time viral monitoring, its low cost and ease of use could make it a simple way to improve viral safety in workplaces and healthcare facilities.
As we learn to live with SARS-CoV-2, our tactics for ...
Source: Medgadget - January 18, 2022 Category: Medical Devices Authors: Conn Hastings Tags: Genetics Medicine Public Health Yale Source Type: blogs
Omicron Symptoms Now Include Loss Of Appetite – Replacing Cough And Loss Of Senses
The sign of the new Omicron variant which can appear when eating. (Source: PsyBlog | Psychology Blog)
Source: PsyBlog | Psychology Blog - January 16, 2022 Category: Psychiatry & Psychology Authors: Jeremy Dean Tags: COVID19 Source Type: blogs
