Intern Case Conference – Ascending Cholangitis
Morning Report
Powerpoint: Ascending Cholangitis Further Reading: Choledocholithiasis, Ascending Cholangitis, and Gallstone Pancreatitis
Management of Cirrhosis – The Basics
Morning Report
Teaching Point
- Common etiologies
- Alcohol
- Hepatitis C and B
- NAFLD
- Complications
- Ascites: spironolactone 100mg/lasix 40mg
- SBP: ceftriaxone 2gm IV q24h
- Hepatic encephalopathy: lactulose, neomycin/rifaximin
Intern Case Conference – Acute Coronary Syndrome
Morning Report
Here is the powerpoint for today's intern case conference on ACS: InternReport.ACS Guidelines: AHA/ACC Guideline for the Management of Patients With Non-ST-Elevation Acute Coronary Syndromes ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction Further Reading: Mechanisms of ACS and their…
Drug-Induced Liver Injury
Morning Report
Thank you Dr. Reynolds for an excellent presentation on drug-induced liver injury
Teaching Points
- Patterns of abnormal LFTS
- Hepatocellular: high AST/ALT w/mild elevation in alk phos
- Cholestatic: High alk phos w/ mild AST/ALT
- Causes of hepatocellular injurry
- Alcohol: AST elevation greater than ALT
- Viral: ALT elevation greater than AST
- NAFLD/NASH: AST to ALT ratio typically 1
- Toxins: NSAIDS, abx, statins, anti-epileptic drugs
- Hereditary/autoimmune: hemochromatosis, autoimmune hepatitis, alpha-1-antitrypsin deficiency, Wilson’s disease
- Shock: high elevations in AST/ALT
- Non-hepatic causes: muscle disorders, thyroid issues, celiac disease, adrenal insufficiency, anorexia
Atrial Fibrillation
Morning Report
Thank you Dr. Feng for an excellent presentation on the management of atrial fibrillation in the setting of acute de-compensated heart failure
Teaching Points
- Important components of management: hemodynamic stability, rate control, anti-coagulation
- Rate control agents: beta blockers, calcium channel blockers (not preferred in HF), digoxin and amiodarone (also an anti-arrhythmic)
- Antiarrhythmics for afib are Class IC or III
- IC: flecainide, propafeonone
- III: amiodarone, dronedarone, sotalol, dofetilide
- Anti-coagulation: indicated if CHADSVASc ≥ 2 (warfarin or newer agents, ie apixaban or rivaroxaban)
Intern Case Conference 7.6.16
Morning Report
Here is the power point from today’s case conference on the diagnosis and management of Community Acquired Pneumonia. Intern Report 7.6.16
Granulomatosis with Polyangiitis Glomerulonephritis
Morning Report
Thank you Dr. Jang for an excellent presentation on granulomatosis with polyangiitis presenting as lower extremity edema from renal involvement. Teaching Points: GPA can involve multiple organs including nasal ulcers, cartiglage destruction, tracheal stenosis, alveolar hemorrhage, glomerulonephritis, leukoclastic angiitis Diagnosis…