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Just finished a month on inpatient medicine. We often overlook all that we're learning because a service is busy, but our fearless leader, @hcricketfisher, compiled a list of the topics we covered and I'm inspired!

So, some #MedTwitter #MedEd from our team @BrighamMedRes to you:
Why basal-bolus insulin in the hospital? RABBITs, that’s why:

i.e. in an RCT basal-bolus insulin provides better glycemic control than sliding scale alone in non-critically ill, hospitalized patients with type 2 diabetes (and is safe).

pubmed.ncbi.nlm.nih.gov/17513708/
When should we stop broad-spectrum antibiotics? Probably sooner than we do.

i.e. in multiple cohort studies, the probability of true bacteremia if a blood culture has remained negative for 24 hours is reported to be as low as 1.8%!

ncbi.nlm.nih.gov/pmc/articles/P…
Read 26 tweets
Thank you to our PD emeritus Dr. Marshall Wolf & @tmmeade1 for kicking off the week with a case of syncope yesterday!
The 💰 is in the 🗣️!
1. Is this true syncope? Transient LOC + spontaneous and rapid recovery
2. How worried 😱 are you for 💔 etiology? Any ❤️ disease, new chest pain/palpitations, exertional or supine syncope, FHx sudden cardiac death, abnormal VS or ECG should set off 🚨
...May be reassured by syncope stable x years, with clear prodrome & trigger, in a younger individual (<40 y/o)
🤔 In thinking about worrisome etiologies, recurrent syncope less likely to be tamponade, dissection, ACS, PE but arrhythmia🔌💓 still on the table!
Read 6 tweets

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