This week was the last grand rounds of the academic year. We started off with the monthly Morbidity and Mortality conference led by Dr. Colmer. This was followed up by a CPC on Infectious Mononucleosis from Dr. Jensen and Dr. Stolz. Dr. Urbanowicz then discussed if there is a use of platelet function studies in the Emergency Department. The day ended with Dr. Murphy-Crews describing a fascinating case of severe hypothermia and outlining the interventions available to us in the ED for these patients. See you next week!Read More
Dr. McKean kicked off this week with another great M&M where he taught us about the utility of stress testing to predict coronary artery disease, otomastoiditis, and much more. Dr. Brenkert joined us for an hour on pediatric musculoskeletal ultrasound and then Dr. Mudd reviewed transfusion strategies in upper GI bleeding. Dr. Ventura taught us about CSF analysis and Drs. Stettler and Whitford rounded out the day with a CPC about acid-base disturbances.Read More
As 2016 comes to a close, Dr. McKean taught us about transfusion related lung injury, PEs, TCA overdoses, and the use of platelets in ICH during M&M. We learned the basics about the renal panel with Dr. Owens. Drs. Betz and Summers battled it out over drug-induced hepatitis and Dr. McKee taught us about Crypococcal Meningitis in her case follow-up. The year wrapped up with another Levy Cup Pre-season battle lead by Drs. Boyer and Winders.Read More
Morbidity and Mortality Pearls with Dr. Curry
Incidence in the US is 0.5-1% (lifetime risk 10-15%). There is a 2:1 male predominance and the recurrence rate is fairly high (37% at 1 year, 50% at 10 years and 75% at 20 years).
Patients at risk for poorer outcomes with ureterolithiasis are those with risk factors for diminished renal function, history of difficulty with stones/urologic intervention and symptoms of infection.Read More
Radiation in Pregnancy with Dr. Polsinelli
Radiation effects can be deterministic or stochastic.
- Deterministic effects cause direct cell damage (radiation burns, teratogenicity, intrauterine death, genetic material damage). There is no evidence of teratogenicity in diagnostic testing radiation ranges (<50mGy). Genetic damage (causing effects in future generations) is theoretical and has not been reported. IUD is a concern, but on a population based scale there was no noted increase in incidence of fetal demise after large scale radiation event and this cannot be studied in vivo.
- Stochastic effects increase the probability of developing cancer. There is no minimum threshold and increasing dose increases probability. Risk of cancer noted to be ~5% if exposed to 1Gy of radiation. (for comparison maternal radiation is: chest xray = 0.1mGy; CT abd/pelvis 10mGy)