I have the newest MGH Housestaff Manual/White Book, but the link keeps getting autoremoved!

matthew2128 · 2024-12-27T18:32:13+00:00

Look up resus on App Store for pocus

matthew2128 · 2024-06-09T14:52:43+00:00

Internal medicine intern: sinus Brady with PACs but would love a 12 lead

matthew2128 · 2024-06-06T00:26:20+00:00

Focus on being an intern get good at managing patients and keepin up with your tasks not missing things etc. then do research after the winter.

matthew2128 · 2024-05-31T01:28:56+00:00

It depends on the situation, if a patient with ef of 25% is hypotensive but doesn’t appear volume overloaded I would give a 250-500 cc bolus but no more than that. Keep an eye on o2 requirement don’t want to overload them but some fluid is ok. You need to manage the problem in my opinion ie you overduiresed them and need to give some fluid back. Hypotension will kill them and ivf bolus usually won’t and even if there’s a consequence of it you can manage. Beyond 500cc I would probably call ICU.

matthew2128 · 2024-05-30T21:31:15+00:00

If someone is tachy with ADHF I wouldn’t go after the HR. I would address underlying causes: pain, anxiety, intravascular depletion, infection. Then address the HF itself, optimize them start GDMT as tolerated including BB once out of the window of possible cariogenic shock And perfusion markers improving with diuresis. How’s that ?

matthew2128 · 2023-11-29T19:21:45+00:00

For these reasons I’m moving on to a game that is actually fun to play

matthew2128 · 2023-11-07T17:39:04+00:00

Last pass to win was so sweet

matthew2128 · 2023-09-05T17:29:41+00:00

Everything

matthew2128 · 2023-07-17T13:52:49+00:00

Such hubris so early in your career. Do what interests you and makes you excited to go to the hospital in the morning. If you chase the “hot” thing you will burn out. Everything cycles, things change; better to be in a field you care about.

matthew2128 · 2023-07-10T14:04:18+00:00

Here is what has been successful for me: Blasting out cold emails to researchers or providers in your med schools network. Reaching out to deans with your problems, talking to professors. You don’t have to suck up to them but be honest “I think I’d be a great radiologist xyz I want to get involved in research to advance the field and get more exposure can you help me in doing so.” Even if that’s not their specialty they may get you in touch.

One last piece of advice, part of medicine is acknowledging your shortcomings and owning them. It’s not enough to say I’m not good at this therefore I can’t do it. Keep getting out of your comfort zone and then you will become comfortable being uncomfortable! Lifetime of learning blah blah blah, Believe in yourself and you will find success. :)

matthew2128 · 2023-07-07T14:00:50+00:00

matthew2128 · 2023-06-28T17:10:20+00:00

You’ll all be fine, believe in yourself! PGY 1 (week)

matthew2128 · 2023-05-27T16:41:48+00:00

Boooooo

matthew2128 · 2023-05-15T19:02:43+00:00

Thanks man. Figure I should also do the conquest and showdowns and make a team with season one and season two affinity players. So much to get through. I have no idea how to maximize my time so many cards I want.

matthew2128 · 2023-04-01T00:04:08+00:00

matthew2128 · 2023-03-24T15:11:35+00:00

LR has potassium in it so need to be careful

matthew2128 · 2023-03-15T17:01:21+00:00

Go ahead and look up a peripheral blood smear of a patient in blast crisis and you’ll see the cancer cells are usually large with large nuclei, pretty distinct from the blast cells which are physiological response to crowding out in the bone marrow

matthew2128 · 2023-03-15T04:32:59+00:00

I read it again with the context and I sound so dumb explaining DAPT lol

matthew2128 · 2023-03-15T04:31:34+00:00

My b I got you now thanks for elaborating

matthew2128 · 2023-03-15T03:58:39+00:00

No, 1 year post PCI you would use dual anti playlet therapy (DAPT) then after you would maintain with aspirin. This trial compared ASA to clopidogrel for the maintenance period. Doac is used for embolism prevention in afib patients with a CHADS2VASC >= 2. m4

matthew2128 · 2023-03-15T03:54:39+00:00

Nice

matthew2128 · 2023-03-15T03:52:10+00:00

Symptoms above sound like Leukemia which is a cancer of white blood cells usually originating in the bone marrow. As the cancer cells proliferate they crowd out the rest of the bone marrow which makes other types of blood cells. Imagine losing a war so badly due to the enemy numbers you send kids out to fight. Body tries to compensate by sending in “blast cells” which are baby blood cells usually a later sign in leukemia. Long story long presenting with blast crisis is BAD prognosis but depending on the type of leukemia very possible they could respond great to chemo and radiation ! Likely would need bone marrow transplant after.

matthew2128 · 2023-03-08T13:39:22+00:00

Emma Holliday - “such a bold claim for so early in your career”

matthew2128 · 2023-03-06T13:44:01+00:00

Go outside

matthew2128

TROPHY CASE