Hospitalist @LosAngelesVA | Assistant Clinical Professor @dgsomUCLA | #MedEd | #MedSim | Avid gamer and reasonable cat lady | Opinions my own.
Nov 6, 2022 • 5 tweets • 2 min read
Day 1 of inpatient service @LosAngelesVA and already so much learning to be had!
Many of us learn the classic triad of Wernicke's encephalopathy:
⭐️confusion
⭐️ataxia
⭐️ophthalmoplegia
But, turns out <20% of patients have all three components of the triad.
So, how to avoid underdiagnosis of this important illness? Caine criteria were developed by corroborating clinical features with neuropathological diagnosis.
Instead of triad, look for 2/4 of:
⭐️nutritional deficiency
⭐️confusion
⭐️ophthalmoplegia
⭐️cerebellar dysfunction
Oct 20, 2021 • 9 tweets • 2 min read
1/ In the twilight of my pregnancy, I've been thinking about a pregnant resident I worked with in the ICU as a third-year medical student. A thread about pregnancy/childbearing in medical training.
2/ She had apparently started having contractions earlier that evening. We were on 30-hour call and it was a busy night. We admitted something like 8 patients, many of them critically ill. She expertly managed each of them despite her contractions as I watched in awe.
