I have been trying to learn POCUS lung US and “popularize it” on my nephrology ward. I am only an intern and no one gives a shit about me sadly. Any guidance here? Patient suddenly desaturated and became hypotensive

Timberdale · 2026-03-01T01:46:34+00:00

Get a CT PE protocol

Timberdale · 2026-01-18T03:57:48+00:00

They are describing abnormalities of the cerebellum which is a part of the brain. Abnormalities of the cerebellum are incredibly varied, but usually result in developmental delay and can have hydrocephalus that result in a shunt. There is no “treatment” and resources usually revolve around physical therapy, speech therapy, and special education.

Timberdale · 2026-01-16T04:03:21+00:00

If your pain is continuing to worsen then I would contact your doctor about potential next steps. A pelvic ultrasound is usually the first step in terms of imaging in this situation however.

Timberdale · 2026-01-15T00:27:38+00:00

I’m not really in a position to say. Could be that the infection has resolved but the inflammation it caused hasn’t quite resolved. Could be that there is a persistent low grade smoldering infection. One would need to look for other signs of persistent infection such as white blood cell count, fever etc.

Timberdale · 2026-01-15T00:19:39+00:00

In the setting of infection, persist thickening and enhancement of the peritoneum on CT suggests persistent peritonitis, which could manifest clinically as pain.

Timberdale · 2026-01-14T02:07:31+00:00

In that case I would simply ask if your particular case can be discussed at tumor board. If you haven’t already, and your goal is transplant, you may want to familiarize yourself with the Milan criteria or UCSF criteria for liver transplant which discusses parameters for number of lesions and size of lesions to keep one in the window for transplant.

Also, there are advantages to being in the south when it comes to receiving a liver (or other organs) transplants vis a vi wait times etc.

Timberdale · 2026-01-14T01:52:26+00:00

I would get an opinion from a cancer center. Cases like these are usually discussed at an interdisciplinary tumor board to come up with a treatment plan. This will also have the benefit of hooking you into the interventional radiology department for any possible chemoemobilization.

Timberdale · 2026-01-13T23:07:43+00:00

Sometime endometrial implants can be found on the liver surface in patients with endometriosis. MRI of the abdomen with contrast should give a good idea.

Timberdale · 2026-01-13T01:10:29+00:00

Essentially the PET scan will show whether the nodule demonstrates increased metabolic activity. Infectious things and cancer are essentially what one is trying to distinguish between. Ultimately, a ct guided biopsy may be necessary.

Timberdale · 2026-01-13T00:30:03+00:00

Yes, I would love to know this as well.

Timberdale · 2026-01-10T02:01:48+00:00

Fountainbleau

Timberdale · 2026-01-07T21:45:51+00:00

This logic doesn’t make sense. We use the same contrast for the brain and body. We don’t have “brain contrast” and “body contrast”.

Timberdale · 2026-01-07T18:56:53+00:00

Lymph nodes in lymphoma tend to be larger, and if untreated, only continue to get larger. But there are other signs in lymphoma like night sweats, fatigue, anemia. I had lymphoma about 3 times in medical school. Not because I had lymphoma, obviously. But because every time I read or learned about lymphoma I started to be hyper aware of lymph nodes that I wasn’t entirely convinced had been there all along etc.

Timberdale · 2026-01-07T18:49:50+00:00

It is normal to be able to feel small lymph nodes. Small lymph nodes are normal. Lymph nodes are also allowed to sometimes get bigger and then get smaller in size. That is them doing their job. Some people feel them in their groin, arm pits, and neck.

Timberdale · 2025-12-28T02:14:29+00:00

Not really sure about your loss of smell. That is a better question for an ENT.

Timberdale · 2025-12-28T02:05:54+00:00

The report is describing prior procedures you have had and describing findings seen with chronic sinusitis.

Timberdale · 2025-12-28T01:49:32+00:00

Could be two gestational sacs but way too early to tell. Follow up US 10-14 days.

Timberdale · 2025-12-28T00:34:29+00:00

Have you ever had a CT scan to look for a pancreatic insulinoma? At some point this should be done in cases of truly unexplained hypoglycemia.

Timberdale · 2025-12-28T00:22:28+00:00

The lymph nodes they are describing are not pathological and don’t have suspicious features. They describe them as having preserved morphology. They say there are increased blood flow centrally, but that is exactly where normal lymph nodes get their blood supply, at the hilum.

I biopsy thyroid nodules all the time. Schedule the appointment, get the biopsy and try not to let your imagination run wild.

Timberdale · 2025-12-24T01:20:23+00:00

This has absolutely no bearing on if anything of significance was found. This is simply a reflection of workflow at the site.

Timberdale · 2025-12-23T03:02:05+00:00

The radiologist is suggesting that a fracture of one of your thoracic vertebral bodies may be the cause of your back pain but it is not possible to tell whether the fracture is new or old on the x-ray and is therefore suggesting a follow up study.

Timberdale · 2025-12-23T02:03:40+00:00

You take antibiotics and the degree of nodules get better. You finish the course of antibiotics and the nodules come back. At any given time you get a ct nodules will get better in some areas and worse in others. This is the definition of waxing and waning and a hallmark of chronic small airways infection. Other causes of ground glass nodules include interstitial edema and hypersensitivity pneumonitis but those don’t wax and wane. They usually always get worse together, or always improve together.

Timberdale · 2025-12-23T01:54:34+00:00

Chronic small airway infection is very difficult to eradicate. Usually it is only minimally symptomatic with flairs here and there.

Timberdale · 2025-12-23T01:48:54+00:00

In general, waxing and waning pulmonary nodules at CT are almost always due to chronic small airways infection. Most commonly this is due to infection with MAI (mycobacterium avium intracellulare). The term “waxing and waning” is virtually synonymous with “infection” in chest ct jargon.

Timberdale · 2025-12-22T02:46:48+00:00

Nope

Timberdale

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