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.
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.
What is primary care? (revisited)
I generally avoid using the term for this reason. I hope this discussion emphasizes the importance of the semantics.
On perioperative beta blockers – another hole in the performance indicator movement
I am interested in the ability of the performance movement to adjust. Of course, they will shrug off the unintended consequences that they caused here.
Reasons to become a doctor
I will agree that if your goal is to get Rich (rather then just very well off) you should choose another career.