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Most recents (2)
get pumped 👊 for more pulm #twearls from @galbamd tomorrow, but here's what we learned after part 1 of gas exchange today...
1/ 72yoM with COPD (FEV1 0.5L ~25% predicted) is admitted with a COPD exacerbation with accessory muscle use, RR 33, SpO2 84% and ABG 7.3/80/55. He is placed on NRB with improvement in SpO2 to 100%. He becomes obtunded and repeat ABG is 7.1/110/50. Why?
1. loss of pulmonary hypoxic vasoconstriction👉V/Q
mismatch
2. Haldane effect: during conditions of increased oxygen
tension, there is increased CO2 displacement from Hgb
in the pulmonary circulation
mismatch
2. Haldane effect: during conditions of increased oxygen
tension, there is increased CO2 displacement from Hgb
in the pulmonary circulation
#FirstTweet! We will be sharing hepatology #Twearls from this morning's res report led by GI fellow extraordinaire @JacquelineChuMD!
2/5💡"Not all cirrhotics are created equal"-> It's important to distinguish compensated from decompensated cirrhosis! The latter indicates a much worse prognosis.
Some hallmarks of decompensated cirrhosis:
▪️ascites
▪️hepatic encephalopathy
▪️variceal bleed.
Some hallmarks of decompensated cirrhosis:
▪️ascites
▪️hepatic encephalopathy
▪️variceal bleed.
3/5💡Hepatic encephalopathy is not a stand-alone diagnosis. It's a sign of an underlying issue & you need to find the cause!
For that, you can turn to VIBES!
For that, you can turn to VIBES!
