Read on Twitter
1/n
fUnKy Inflammation
Yup.
You are reading this right.
fUnKy Inflammation!
A thought exercise...
Who said learning medicine can't quirky and fun?!?
Let's go
fUnKy Inflammation
Yup.
You are reading this right.
fUnKy Inflammation!
A thought exercise...
Who said learning medicine can't quirky and fun?!?
Let's go
Wait, what do you mean by inflammation?
So glad you asked.
There are many roads that lead to the conclusion that a syndrome has features of inflammation.
Fever is the most specific, but there are many other paths.
More here - https://bit.ly/2VXeky0
So glad you asked.
There are many roads that lead to the conclusion that a syndrome has features of inflammation.
Fever is the most specific, but there are many other paths.
More here - https://bit.ly/2VXeky0
How is this helpful?
Well, when there is inflammation, we have a path towards a Dx:
@DxRxEdu's terrific mnemonic - iMade
Infection
Malignancy
Autoimmune
Drugs
Endocrine
Thoughts on an endorsement @Apple
?
Well, when there is inflammation, we have a path towards a Dx:
@DxRxEdu's terrific mnemonic - iMade
Infection
Malignancy
Autoimmune
Drugs
Endocrine
Thoughts on an endorsement @Apple
?
@Sharminzi and @jackpenner would tell you to prioritize Infection
Here is them systematically walking us through the infection category: https://clinicalproblemsolving.com/dx-schema-infection-in-the-inpatient/
Here is them systematically walking us through the infection category: https://clinicalproblemsolving.com/dx-schema-infection-in-the-inpatient/
Eventually, we move on to think about
Malignancy
Autoimmune
Drugs
Endocrine
Malignancy
Autoimmune
Drugs
Endocrine
Did you notice that this entire journey is made without much regard to the nature of the inflammation?
We just basically said:
Inflammation = iMade
Prioritize the "i" and then move on to the Made.
We just basically said:
Inflammation = iMade
Prioritize the "i" and then move on to the Made.
But...
What if the inflammation in fUnKy???
There are the two best definitions of funky that I came across:
1. different but cool, nice
2. unconventionally stylish
What if the inflammation in fUnKy???
There are the two best definitions of funky that I came across:
1. different but cool, nice
2. unconventionally stylish
From the lens of the LABS, most inflammation if predictable...
The WBC is elevated and is neutrophilic.
Action step - jump right into iMade
Sometimes, though, there is a nice, cool, and maybe even a stylish surprise...
The WBC is elevated and is neutrophilic.
Action step - jump right into iMade
Sometimes, though, there is a nice, cool, and maybe even a stylish surprise...
Isolated Leukopenia...
It may be a feature of sepsis, but definitely sways the DDx.
You'll be thinking of some less common infections, prioritizing drugs, and a subset of autoimmune diseases and cancers.
It may be a feature of sepsis, but definitely sways the DDx.
You'll be thinking of some less common infections, prioritizing drugs, and a subset of autoimmune diseases and cancers.
Isolated Leukopenia...
Examples
1. This incredible @hdx case from @sargsyanz
https://bit.ly/3cbYcgY
2. This @CPSolvers morning report case from @INizamuddinMD https://bit.ly/3aXorHE
Examples
1. This incredible @hdx case from @sargsyanz
https://bit.ly/3cbYcgY
2. This @CPSolvers morning report case from @INizamuddinMD https://bit.ly/3aXorHE
Lymphocytosis...
Again...dramatically shifts the Dx considerations in the iMade mnemonic
Again...dramatically shifts the Dx considerations in the iMade mnemonic
Eosinophilia...
Now the spotlight is on fungal and parasitic infections.
eGPA is the leading autoimmune disease
You'll also mull the possibility of a myeloproliferative neoplasm..
Now the spotlight is on fungal and parasitic infections.
eGPA is the leading autoimmune disease
You'll also mull the possibility of a myeloproliferative neoplasm..
HLH...
Cytopenias, a super high ferritin, high triglycerides and a low fibrinogen, also shift your iMade considerations
Watch this @CPSolvers report from @tarheel_doctor - the Dx considerations change as soon as these labs above are revealed...
https://bit.ly/3a2V4CC
Cytopenias, a super high ferritin, high triglycerides and a low fibrinogen, also shift your iMade considerations
Watch this @CPSolvers report from @tarheel_doctor - the Dx considerations change as soon as these labs above are revealed...
https://bit.ly/3a2V4CC
Let's recap...
From the perspective of the labs...
1. Most inflammation is predictably neutrophilic
2. Sometimes, though, you see a pretty fUnKy lab signature, which can dramatically shift your Dx hypothesis.
Can you think of others?
From the perspective of the labs...
1. Most inflammation is predictably neutrophilic
2. Sometimes, though, you see a pretty fUnKy lab signature, which can dramatically shift your Dx hypothesis.
Can you think of others?
The evidence for all of this?
I have none.
This is a thought experiment, and I would LOVE your input.
The best way to do so?
Join us and let's Learn-Live! together
More here - https://bit.ly/2yTkvcW
I have none.
This is a thought experiment, and I would LOVE your input.
The best way to do so?
Join us and let's Learn-Live! together
More here - https://bit.ly/2yTkvcW
