GM3
If a patient's CD4 count is under ____ and they are stable/not here for primary infection, Hospitalist can likely accept.
200
If a patient is appropriate for Hospitalist, stable yet slightly more complex - where should we think about assigning them?
Senior Med
What is the #1 diagnosis that should be prioritized for GM2 placement?
Active/decompensated cirrhosis
Name of the Infectious Disease Clinic
HP6
Alzheimer, definite or probable, and vascular dementia with medical complications or functional decline preventing care at home should be admitted to what service?
Medicine
Gen Med 2 team is made up of a generalist (typically Hospitalist and/or outpatient medicine attending) and what 2 other specialists?
Hepatologist & GI Specialist
What is the rationale for placing a patient with concerns for meningitis/encephalitis/thoracentesis on GM3 team besides the obvious r/o infection?
Residents need to perform a certain number of procedures during training
With uncomplicated meningitis, odd MRN numbers go to ________, even numbers go to _______.
Odd = Neurology
Even = Medicine
If cirrhosis is present yet not the primary reason for admission or active what are the two teams can they possibly go to?
GM2 and Hospitalist
Patient admitted with UTI secondary to obstructive stone disease should be admitted to what team?
Urology
KEY word = obstructive!
Does the following patient meet criteria for admission for medicine service and what is your rationale?
45 y/o male with hx of HIV, ETOH abuse and liver transplant in 2018 with c/c of swelling and pain to right lower leg after arrival from Japan 2 days ago.
Yes! Liver transplant surgery greater than 5 years ago and no transplant specific complication meets the criteria for a non-transplant service such as medicine.
Admitting guidelines refer to what type of patient's diagnosis?
Primary or most serious.
In-depth answer: "If patient is admitted with multiple diagnoses, the most serious, immediate, or life-threatening diagnosis takes precedence with the understanding that full support from the other Services will be provided via consultation."
Does the following patient meet criteria for admission to medicine service and what is your rationale?
85 y/o female with hx of ESRD on HD, GIB, HIV with CD4 count of 200, CTAP shows free intra-abdominal air and a perforated bowel. Patient refusing surgery and surgical c/s states admit for medicine for IV antibiotics.
Refusal of surgery does not automatically exclude adm to surgical service, since they can manage certain conditions non- operatively. The admitting guidelines don't specify where a perforated bowel should go, but they do specify that the patient's primary diagnosis should take precedence.
The guidelines also state that "the ED team should always contact the Surgical Attending directly before the admission to ensure the surgeon agrees with the disposition decision." So, if the surgery team decides not to admit, it will need to be an attending to attending discussion.