@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…
@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…
@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…
@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…
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…
@JoePinero – Much literature has been devoted to the attempt of proving the benefit of fasting as it relates to dangerous aspiration events during intubation or procedural sedation. Despite an overwhelming amount of literature pointin…
@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…
@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…
@JoePinero Every critical care physician scoffs at the idea of placing a femoral central line, but are they correct? Do femoral central lines actually cause more infections than other sites?
@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…
by @JoePinero The next time you have a patient with a dislocated jaw, hand them a 5cc or 10 cc syringe and tell them to stop, drop, bite and roll!
Post by @JoePinero 25 yo M no phx, from Ecuador, in US for 6 months, CC 1 month of cough w/speckled hemoptysis, +intermittent subjective fevers responsive to tylenol/motrin. +Wt loss of 7-10 lb’s in past month. In Ecuador worked as fi…
A recent study published in JAMA, “Medicine’s Uncomfortable Relationship With Math: Calculating Positive Predictive Value,” highlighted a massive hole in our education. Out of 24 attendings, 26 residents, and a handful of…
