Things we discussed last week on rounds

Each week on rounds several very interesting topics arise.  In December I plan to discuss these issues on a daily basis, but today I am reflecting on 5 days of ward rounds last week.  I just plan to list some issues, not include the discussions or why we focused on those issues.  Please feel free to ask questions or request a longer post on an issue. When to give bicarbonate for metabolic acidosis – increased versus normal gap acidosis How you can have both a metabolic alkalosis and acidosis at the same time When to aggressively evaluate an anion gap acidosis What is community acquired pneumonia and when should we consider other diagnoses How to manage NSTEMI Differentiating between cellulitis and soft tissue abscess Evaluating the patient with newly altered mental status and how to interpret an elevated ammonia level What is procalcitonin and when should we use it Why do patients binge drink How do you work with patients who leave against medical advice and return in 6 hours How to treat acute pancreatitis in 2017 When should we use normal saline, and when do we use Ringer’s lactate Just 5 days of rounding, and this is an incomplete list.  Inpatient internal medicine is very complex.  As clinician educators we should be fluent in all the above issues, and many many more.  Many of these issues have excellent informative data to support our decision making; while others have less complete data.  Nonetheless we must make decisions about diagnostic evaluatio...
Source: DB's Medical Rants - Category: Internal Medicine Authors: Tags: Medical Rants Source Type: blogs