July 30th, 2011 by ChristopherChangMD in Research
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From the pages of CSI: Miami… a commonly used forensic chemical called luminol to identify traces of blood at crime scenes has been modified to be used in a novel medical test that can help differentiate a viral infection from a bacterial infection.
Why is this important?
Not uncommonly, it is sometimes hard to differentiate between a bacterial infection which is treated with antibiotics from a viral infection which is NOT treated with antibiotics. Unfortunately, in the healthcare system, too often, antibiotics are given if an infection is present whether viral or bacterial which is leading to multi-drug resistant infections like MRSA.
Well with this test, Read more »
*This blog post was originally published at Fauquier ENT Blog*
March 17th, 2011 by ChristopherChangMD in Health Tips, Opinion
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Occasionally, I see patients who have received throat swabs for strep that have come back positive… even if they have no signs or symptoms of pharyngitis.
In this situation, there are 2 main actions a physician may take (I am biased towards one):
1) Prescribe antibiotics until throat cultures are normal
2) Do nothing
Personally, if a patient is without throat symptoms and has no history of rheumatic fever or kidney damage, I would not have even bothered obtaining a strep test. What for??? Read more »
*This blog post was originally published at Fauquier ENT Blog*
November 28th, 2009 by Nicholas Genes, M.D., Ph.D. in Better Health Network, True Stories
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I took my board exam this week, and I think I liked it.
Which is not to say it was easy, or even altogether fair. And though I felt a little bit better upon finishing than these folks, I could be grossly deluded in my estimation of the number and trickiness of truly tough questions.
But there was a point in the exam, three or four hours into it, when I was overcome by the sheer variety of extraordinary patient presentations — the environmental catastrophes, bizarre overdoses and bites from creatures great and small. Overcome, not because I’ve never seen patients like this (for the most part, I haven’t) or because I didn’t know how to diagnose and manage them (I think I did), but really because these questions underscored what an amazing specialty I’ve chosen. Read more »
*This blog post was originally published at Blogborygmi*
September 30th, 2009 by Happy Hospitalist in Better Health Network, Primary Care Wednesdays
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To be a great internist you have to be great at blood gas interpretation. And you have to be able to do it quickly and efficiently. You have to understand what all the numbers mean and you have to get a good clinical sense of how to interpret them and how to change management based on their result. And you have to be able to do it without pulling out your formula books. In six years as a hospitalist I have never calculated what the compensatory responses should be. I just know.
Sometimes blood gases change your management or your medical opinion on what’s happening. Take for example my patient with advanced MS. She presented through the emergency department with “oropharyngeal bleeding of unclear etiology”. Her original BMP:
Na 137
K 4.0
CL 99
HCO3 36
BUN 35
CR 1.0
Read more »
*This blog post was originally published at A Happy Hospitalist*
March 10th, 2009 by CodeBlog in Better Health Network
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One of our patients came off sedation and was extubated.
A few hours later, the doctor came by to assess the patient’s mental status. He asked,
“How old are you, Mr. Smith?”
The patient replied, “I was born in 1924.”
It wasn’t really the answer the doc was looking for, so he asked again,
“But how old are you?”
And the patient looked up at the doctor and said,
“You do the math.”
**This post originally appeared at Gina Rybolt’s CodeBlog.**
