1/ A reminder that while the clinical presentation of COVID-19 varies, a large proportion of adults in the U.S are susceptible to severe disease, more than 40% ‼️
Obesity is a key risk factor.
READ: It's not just people in nursing homes!
2/ Dr. Fauci discusses COVID-19 vaccines💉
He is optimistic that we might get one by the end of the year. He also highlights the disturbing racial inequities with the pandemic and how vaccine trials should include underrepresented minorities!
🔵 Don't underestimate things, learn from what happened w the HIV epidemic!
🔵We need to always do ethically & scientifically sound research during an outbreak
🔵We have to be flexible enough to change guidelines based on the emerging data
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1/ 34 y/o F with new AML dx on chemo (7+3) ANC 200. Counts are expected to continue to drop & not get better for at least another ~10d. Has been febrile 🌡️🔥 & on cefepime 2g q8 for the past 5 days💊💉. What do you do next?
1/36 y/o F hx of anxiety p/w a 2nd episode of transient chest pain w emotional stress & her admission EKG shows 4 mm ST elevations in leads V1-V3. Her 1st troponins check was high. She is currently chest-pain free & vitals are normal.
3/ You look up and notice the STEMI pathway chart conveniently plastered above your workstation‼️
You recognize the patient's presentation is consistent with ACS and her ST elevations meet criteria for STEMI---> you appropriately escalate and decide to call "code STEMI" 🚨📞
3/ What are your ULT options? Check out the awesome slide below.
Takeaways:
💊Start with allopurinol! It will give you the biggest bang for your buck
💊Your target UA level is 6⃣- titrate q2-4 weeks
💊Start prophylactic therapy at the same time (NSAID, colchicine, pred)
2/ First, the spleen is a complex, beautiful & underrated organ. There, we said it. 🤷
It’s so great that 15% of people have an extra accessory spleen
The spleen has 3 general components: A marginal zone & 2 pulps.
3/ ↔️Marginal Zone: Free-flowing transit space for immune cells, where antigens are captured by dendritic cells and B cells (i.e. as APCs) prior to migration to white pulp.
⚪️White Pulp: Physically exclusive lymphoid tissue where T and B cells mature 👶👧👩👵