More on diagnostic errors
We continue to have a health care payment system that rewards procedures – surgery, invasive cardiology, radiology, etc.
In which advocates rethink performance indicators
Yesterday, the NEJM released several important articles which challenge blood sugar tight control as a means of decreasing complications.
And Lemierre’s can kill
I collect newspaper articles about this disease as well as reading medical articles. This story saddens me greatly – an ode to Justin.
Heart failure guidelines
I would make this suggest to cardiologists and heart failure experts – understand how to help generalists learn these important concepts.
Memorial Day
Today I want everyone to think of the veterans. Many medical students and residents make light of the veterans’ contribution to this country.
Answer to 30 year old jaundiced man
His normal alkaline phosphatase argues strongly against extrahepatic obstruction. His normal albumin and INR argue against cirrhosis.
A jaundiced 30 year old man
A 30-year-old male with fatigue, anorexia, and lost taste for cigarettes shows elevated AST/ALT, bilirubin, and normal INR, suggesting acute viral hepatitis.
I am an internist – I am proud
One nephrologist I met yesterday described himself as a militant internist. I liked that phrase, because that is what I am.
The liver puzzle answered
The albumin was low but not what we would expect with cirrhosis. The other liver tests were remarkably normal.
A liver puzzle
The patient had large volume paracentesis. The SAAG (serum ascites albumin gradient) was 1.8 – consistent with portal hypertension.