Category Archives: Internal Medicine

Moffet’s Pediatric Infectious Diseases, 5e (2017)

I write with reverence about what I believe to be one of the best medical books of all time: Moffet’s Pediatric Infectious Diseases, 5e (2017). The main problem with tackling infectious diseases from a diagnostic standpoint is that ID can be hard to classify clinically. The traditional approach is, basically, to ask the question Does the patient have an infection and,… Read More »

The Clinical Significance of the Various Descriptions of Vomitus

Undigested food → esophageal issue (e.g., pharyngeal pouch or achalasia). Note: this is not really vomiting, but regurgitation, which is much less forceful and does not come from the stomach (and therefore not associated with nausea!) Non-bilious, with partially digested food → Gastric outlet obstruction (e.g., from peptic ulcer disease or malignancy, or from pyloric stenosis) GastroparesisVomiting Bilious (green) →… Read More »

Central vs. Peripheral Vertigo Simplified

The first and most important step in evaluating a patient with vertigo is to attempt to distinguish vertigo of central origin from vertigo of peripheral origin because the management of central vertigo (brain imaging, hospital admission) is very different from the management of peripheral vertigo (symptomatic treatment, outpatient referral). Differences Between Central and Peripheral Vertigo Peripheral Vertigo Central Vertigo Percentage… Read More »

Headache: The Ominous Causes

Introduction Most headaches are benign and do not require a specific workup. Here are the ominous ones that require a specific workup and management. From the Patient History Sudden, severe, and maximal at onset, especially in an older patient without a prior history of headaches → subarachnoid hemorrhage → get a head CT without contrast → CT angiogram or cerebral angiogram. Systemic… Read More »

How to Remember the Causes of Arrhythmias (the H’s and T’s)

Causes of arrhythmias, including asystole, include: H‘s: think about what blood does: Volume (hypovolemia) Oxygen (hypoxemia) Glucose (hypoglycemia) Potassium (hypo- or hyperkalemia) Acid-base balance (H+ or acidosis) Temperature regulation (hypothermia) T‘s : imagine a (toxic) lead bullet piercing a chest. What can it cause? Trauma Toxins Tamponade Tension pneumothorax Thrombosis (PE or MI) Reference Dr. Christopher Gallagher’s YouTube video

How to Protect Yourself in the Event of an Ebola Outbreak

Here is a leading expert’s advice on how to protect yourself in the event of an Ebola outbreak: Do not travel to endemic areas. Avoid crowds: To the extent possible, stay at home. Do not go to cinemas or shows. Do not attend community meetings. Avoid healthcare facilities: emergencies excepted, avoid all hospitals, medical clinics, and doctors offices. Avoid medical… Read More »