Surviving Sepsis
Pulm History
X-Ray Spot Dx
Dubitando ad veritatem venimus
"Visual" Dx
200
For adults with possible septic shock or a high likelihood for sepsis, the recommendation is administering antimicrobials immediately, ideally within this time frame
1 hour of recognition
200
René Laënnec is considered by many to be the Father of Pulmonary Medicine owing to his invention of this commonly used medical instrument
The stethoscope
200
RMSB Intubation
200
Of more than 3,000 studies published from 2003 through 2017 in JAMA and the Lancet, and from 2011 through 2017 in the New England Journal of Medicine, more than one of 10 amounted to a “medical reversal”: a conclusion opposite of what had been conventional wisdom among doctors.
1. What commonly used over-the-counter supplement thought to reduce the risk of heart disease has been shown to be ineffective based on a 2019 randomized controlled trial published in the NEJM, yet continues to be used widely especially by the elderly
Omega 3 fatty acids/Fish Oil
VITAL Trial
January 3, 2019
N Engl J Med 2019; 380:23-32
DOI: 10.1056/NEJMoa1811403
200
What Profession/Sport is this seen in?
Cauliflower Ear or Auricular Hematoma
Boxing, rugby, and wrestling
400
For adults with sepsis or septic shock, the guidelines recommend initiating insulin therapy at a glucose level persistently above this level
> 180mg/dl
400
Phthisiology, a historical sub-field of pulmonology is the care, treatment, and study of this disease of the lung
TB
400
Feeding tube in the right pleural space
Why all of you need to be certified in entec placements
400
This commonly prescribed replacement therapy has not been shown to benefit cognitive function in men, even if the patient has a documented deficiency.
Based on this 2017 RCT published in JAMA
Testosterone
JAMA 2017 Feb 21;317(7):717-727. doi: 10.1001/jama.2016.21044.
Conclusions and relevance: Among older men with low testosterone and age-associated memory impairment, treatment with testosterone for 1 year compared with placebo was not associated with improved memory or other cognitive functions.
400
Name the Disease:
Grave's Disease
Actually, the condition gets its name from Robert Graves, an Irish doctor who first described the condition in the 1800s
600
The new guidelines recommend against using this risk calculator tool compared with SIRS, NEWS, or MEWS as a single screening tool for sepsis or septic shock.
qSOFA
600
Philip Drinker, PhD (1894-1972), and Charles McKhann, MD (1898-1988), at Boston Children’s Hospital and Harvard published a paper describing the successful use of an artificial respirator, the machine, first known as the Drinker respirator would later come to be called by this popular name
The Iron Lung
600
Deeply positioned CVC (why you don't use the 23cm one for an RIJ placement )
600
To treat emergency room patients in acute pain, a single dose of oral opioids is no better than...
based on a large randomized clinical trial published in JAMA in 2017
A dose of ibuprofen/acetaminophen
JAMA. 2017;318(17):1661-1667. doi:10.1001/jama.2017.16190
Meaning: For adult ED patients with acute extremity pain, there were no clinically important differences in pain reduction at 2 hours with ibuprofen and acetaminophen or 3 different opioid and acetaminophen combination analgesics.
600
Name the Disease from this sign:
Moon Facies - Cushing's syndrome
800
For adults with septic shock and hypoperfusion-induced lactic acidemia, we suggest against using this therapy to improve hemodynamics or to reduce vasopressor requirements.
Sodium Bicarbonate
800
In April 1955, 13-year-old Susie Maison asked her father, the pharmacologist George L. Maison, whether there wasn’t an easier way to treat her asthma. This would in only 2 months lead to the invention of this famous and now commonly used device
The metered-dose inhaler
800
Hint: Cough for 1 week
Spontaneous pneumomediastinum with typical continuous diaphragm sign is present.
Spontaneous subcutaneous emphysema also noted.
800
As demonstrated by an RCT published in JAMA 2020 called the VDKA Trial, supplementation of this vitamin does not prevent asthma exacerbations even in cases of documented deficiency
Vitamin D3
JAMA. 2020;324(8):752-760. doi:10.1001/jama.2020.12384
The findings from this trial do not support the use of vitamin D3 supplementation to improve the time to a severe asthma exacerbation in children with asthma and low serum vitamin D levels
800
Name the Disease:
Migraine (means half-skull)
The term migraine is derived from the Greek word hemikrania. This term was corrupted into low Latin as hemigranea, the French translation of which was migraine.
1000
For adults with septic shock, we are recommended to use norepinephrine as the first-line agent over other vasopressors.
Among other pressors, the quality of evidence against use is strong only for this agent
Dopamine- High
Vasopressin- Moderate
Epinephrine- Low
Selepressin- Low
Angiotensin 2- Very low
1000
The "Newest" of the standard 4 first-line drug therapy for TB, this drug was discovered in 1965
Rifampin
1000
There is a right basal pneumothorax seen with a maximum intrapleural distance measuring 4.6 cm. No mediastinal shift, consolidation nor pleural effusion is observed.
1000
this supplement, widely used in ancient Chinese medicine and still is promoted as a way to preserve memory, has been shown to be ineffective for the prevention of dementia based on a 2009 Federal study published in JAMA
Ginkgo Biloba
JAMA. 2009;302(24):2663-2670. doi:10.1001/jama.2009.1913
Conclusion: Compared with a placebo, the use of G Biloba, 120 mg twice daily, did not result in less cognitive decline in older adults with normal cognition or with mild cognitive impairment.
1000
Great Albums, Bad syndrome:
HELLP Syndrome
Album name: Help!