Grand Rounds Summary 10.4.17

Grand Rounds Summary 10.4.17

This week Drs. Jarrell and Nagel kicked off Grand Rounds with their evidence based review of the hypertension management in the ED. Drs. Gorder, Lagasse, O'Brien, and Polsinelli discussed the difficult management of the patient in both cardiogenic and septic shock, reviewed heart murmurs, and endocarditis. Dr. Bryant made us squirm with her Global Health quick hit case review of parasitology, Dr. Lane led a great group discussion about the utility of procalcitonin in adults, and Drs. Habib and Roche ended Grand Rounds with a great CPC case!

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Global Health Case Files #2

Global Health Case Files #2

Imagine:  you are the single provider manning a rural clinic in Northern Tanzania along the shore of Lake Victoria.  You are one of only a handful of physicians in the entire region and you have minimal access to diagnostics or therapeutics.  Your clinic does not have any power.   Your diagnostics include:  urinalysis, urine pregnancy, CBC and rapid tests for HIV, syphilis, and malaria.  You have 2 nurses, one of whom acts as a translator (from Swahili to English).  You are armed primarily with your intellect, knowledge of local disease processes, and your keen sense of intuition.

Case #5

32 yo M PMH HIV p/w LLE >RLE swelling & pain x 1 year.  Recent HIV+ and recently started ARVs.  CD4=40.  Pt denies trauma.  No history of DM or CHF.  No fevers, chills, N/V, abd pain, diarrhea.

PE:  37CHR-86BP-124/82RR-12

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