Penn State Internal Medicine Student Report

@NickDuca57 @BMcGillenMD @davidshoremd

12/12 ILD should be on your differential when evaluating patients with chronic dyspnea! If you rotate on #pulmonarymedicine you will absolutely see ILD in clinic! Educators, please add your clinical pearls! #MedEd @duca @mcgillen @davidshore

1/12 #IMPearls 55 yo F w/ a PMH of rheumatoid arthritis visits the doctor with 8 months of progressive SOB on exertion and dry cough. She has a 25-year smoking history. Bibasilar inspiratory crackles on exam. PFTs show a reduced TLC and DLCO. High-res CT shown.

11/ Want to learn more? Here is a great podcast by @thecurbsiders on cirrhosis: thecurbsiders.com/medical-educat… Educators feel free to add your #IMpearls #MedEd #MedTwitter @NickDuca57 @BMcGillenMD @klkrok @KofiClarkeMD

10/ ◽️ Change in mental status - This could indicate hepatic encephalopathy which can be supported by elevated ammonia on labs. ✨ Recent TIPS procedure can lead to reduced hepatic elimination of ammonia and actually worsen encephalopathy ✨ This is a classic board question!

1/ #IMpearls #MedTwitter A 64yoM with a PMH of significant alcohol use presents with his partner due to progressively worsening confusion, a distended and tender abdomen, fever, and jaundice. His partner says he has stopped taking his medications. Here is a CXR from the ED: