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 Dizziness...

Keeping it simple.

Let's head to the triage room - we have a patient waiting.

You:
Feeling dizzy?
I am sorry!

Do you mind holding still for a few seconds?
How does that feel?
Pt #1: Much better!

You (internal dialogue): Phew. Probably not a stroke.
BBPV vs presyncope?

You: Great!
Does it come back when you move your head?
What about standing up?

Depending on the conversation and exam our toolkit is
1. Vitals
2. Orthostatics
3. Dix-Hallpike
4. EKG
Pt #2: Not good...it's still there.

You: Ugh. I am sorry.
Let us take a look at your eyes moving.
Aah. We see why you are dizzy (explain nystagmus to patient)
We are going to do a short exam to help us understand why.
The HINTS is awesome but requires ALOT a practice
Get your reps in!
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More from @rabihmgeha see all

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Rabih Geha
@rabihmgeha
Teaching Rounds

Diarrhea - Part 1

3 Misleading Mimics
&
2 Key Questions

Join us #medtwitter & #medstudenttwitter
Diarrhea = increase in stool water content.

We tend to use the term loosely (Ha! 😉) so your patient may be referring to another change in bowel habits when they say diarrhea.

How do we know?

The Bristol Stool Chart!

bit.ly/2TWeVgS
🙏🙏 @Dietitianbytes
3 Misleading Mimics...

1. Constipation + overflow

2. Stool incontinence

3. Hyperdefecation
This amazing @COREIMpodcast case is a great example - bit.ly/332uDuR

I've been fooled by all 3...multiple times.
Read 18 tweets
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Rabih Geha
@rabihmgeha
Teaching Rounds Day 4

Anemia - Part 2

Slow loss
&
The Bone Marrow Factory

Check out part 1 here -bit.ly/2PJRo18

Join us #medtwitter & #medstudenttwitter
Ok, let's get out bearings..

1. Is there an approach to anemia?
I don't think so - we need a time course.

2. If you don't have a prior HgB, use the clues below to tease out between acute and chronic anemia.

3. Acute anemia =
Bleeding
Hemolysis or
Acute marrow disease
With me?

Cool - 👊

Let's take on chronic anemia and bring this schema to life.

Ready??
Let's go!
Read 22 tweets
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Rabih Geha
@rabihmgeha
Teaching Rounds Day 3

Anemia - Part 1

Neighbors and Time Zones...

Join us #medtwitter & #medstudenttwitter
Claim:
It's nearly impossible to have an approach to anemia.

Yup, impossible.

It's as tough as having an approach to altered mental status?

Wait, what?

Wasn't that the VERY first @cpsovlers episode?
And...what about this schema??
Well, we lied.
Sort of.

That's an approach to ACUTE altered mental status.

Not just any old altered mental status....
Read 22 tweets

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