A prospective trial published in 2012 compared a chloride-restricted fluid strategy with a chloride-liberal strategy for critically ill patients. What were the findings of this study? JAMA 2012;308(15):1566-1572 There was an additional study published in 2015 evaluating hyperchloremia in critically ill septic patients. What were the findings of this study? Crit Care Med 2015 Sep;43(9):1938-44 […]
Author: Geneva Tatem
Hypoxia continued
Continued from previous Case. You bring your patient back to clinic after testing. She tells you she may have had a TIA a few years ago, and that she was recently diagnosed with iron deficiency anemia. 2D ECHO with bubble study reveals bubbles in left ventricle within 1 cardiac cycle (almost immediately) Her ABG on […]
Vent Waveform 1
A patient is agitated during mechanical ventilation and interventions are made to achieve better patient-ventilator synchrony. Flow and pressure curves from before and after the intervention are shown. Based on the change, which of the following best describes the intervention? Matching intrinsic PEEP with Extrinsic PEEP to facilitate triggering each breath Increasing flow rate and […]
Hypoxia
A 52 yo woman is sent to you by her primary care physician for evaluation of hypoxia. She has no symptoms except for early fatigue when she attempts to exercise. She is a lifelong nonsmoker and has no significant past medical history except for hypertension. Pulse oximetry on room air at rest is 80%. You […]
We’re back
A 57-year-old woman presents with worsening shortness of breath over the course of six months. She has lost seven pounds in the past three months and has developed a nonproductive cough. She has never smoked, and has no known mold or work-related exposures. Her only pet is a cockatiel she has had for 18 months. […]
PEEP in ARDS
A 45-year-old previously healthy woman is admitted to the intensive care unit for bacterial pneumonia and severe acute respiratory distress syndrome. She undergoes rapid-sequence intubation with ketamine and rocuronium and receives volume-limited mechanical ventilation with a tidal volume of 6 mL/kg ideal body weight, positive end-expiratory pressure (PEEP) of 10 cm H2O, and FIO2 of […]
New blog posts coming…
Posts have been on a brief break but will re-launch on Feb1st. Posts for both outpatient clinic as well as critical care topics will be uploaded. Stay tuned.
Management of Lung Nodule – continued
Your 54-year-old male patient who is a lifelong nonsmoker comes back to your office for followup of a RUL nodule after a recent biopsy you performed revealed stage IV non-small cell lung cancer. His oncologist said that a “signet ring” sign was seen on his biopsy and that he has a gene abnormality seen on […]
Pulmonary Infections
A new 35 yo patient is referred to you for evaluation of cough. She has had 2 weeks of non-productive cough that has been worsening, to the point of her having fits of cough and post-tussive emesis. Her symptoms started she experienced generalized malaise, but no fever or chills. She denies post-nasal drip, and has […]
Pulmonary Infections
A 38-year-old Korean woman who immigrated to California 6 monthsago complains of weight loss, fever, cough, arthralgia,and frequentbouts of hemoptysis for the past 4 months. She has had no perceptible fever. Chest roentgenograms show a 4.0-cm cavity in the right upper lobe with associated infiltrate. There is a BCG scar on her left arm associated […]