Yet Another Scary Ekg Finding…

@JoePinero As if there weren’t enough morphologies and subtleties in the EKG, here is another ekg finding that you should be aware of… de Winter T-waves 1-3 mm ST-depression upsloping at the J-point in the mid precordial leads l…

Complex Regional Pain Syndrome

@JoePinero 50 yo M hx of NIDDM, recent left shoulder surgery x 4 mo ago for rotator cuff tear, currently presenting with left arm pain from shoulder to hand with swelling and tightness of the left hand and fingers. Exam: Well-appearing male…

Don’t Forget About the Kids….

@JoePinero Quick Case: 17 mo M child presenting with painless bright red rectal bleeding x 1 day. Benign physical exam. Afebrile, with stable vitals and normal labs. Dx: Meckels Diverticulum T99 scan for diagnosis (Sensitivity 85-97%, Speci…

Prisoners Can Refuse Care Too

@JoePinero Prisoners can often cause a lot of ethical dilemma’s when attempting to treat them in the hospital setting. Often times, physicians are reluctant to allow prisoners to sign-out AMA. However, there have been several supreme…

Cardiology Board Questions

1. Which of the following is the earliest EKG finding in acute MI? A. hyperacute T waves B. ST elevation C. ST depression D. T wave inversion E. Q wave 2. Which of the followingis true regarding pediatric EKG analysis? (A) Left axis deviati…

Cannabinoid Hyperemesis Syndrome

@JoePinero – Cannabinoid hyperemesis syndrome (CHS) is a rare diagnosis to make but can save a lot of time and frustration if you can make it. It is typically seen in young males who are frequent users of marijuana, presenting with se…

Rockall Score for Gib

@JoePinero GI bleeds have been a subject of significant research over the past decade. Let’s review the Rockall risk stratification tool. RISK STRATISFICATION TOOL ROCKALL SCORE: Score > 3 = good prognosis (rebleed < 11%, mortal…

I Can’t Turn Left…

@JoePinero A 40 yo M hx of HTN, HLD, DM, PVD, who can’t turn left, is not Derek Zoolander, he’s a man having a stroke!  KNOW YOUR STROKE SYNDROMES!!! As we know, this is a favorite topic of the boards, and will time and again be…

September 2022
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