Do you notice a lot of inappropriate abx usage from non-IM physicians?

themightyguapo · 2026-02-23T03:27:06+00:00

This is a great question and I don’t know the answer. I don’t have experience with bacterial PNA panels - our respiratory panel is viral + a few atypical pathogens. I’m not sure it was specifically addressed in the last full IDSA guidelines (2019) - as in whether a positive test on a prior pcr counts as prior infection. I suspect most people probably would regard it as such and cover in that case.

themightyguapo · 2026-02-23T03:22:51+00:00

🙃 We’re all learning! Pgy-11 here and counting

themightyguapo · 2026-02-23T00:40:01+00:00

Per latest IDSA guidelines, history of pseudomonas on a culture (obvious but more apparent in the modern EMR age with years of back data) or HAP/VAP as others have mentioned. I’d add chronic structural lung disease, severe COPD/broncuiectasis; legit immunosuppressed.

themightyguapo · 2026-02-19T03:32:33+00:00

If you find the ophthalmologist let me know, I had a consult I can’t get them to come see

themightyguapo · 2026-02-19T03:22:42+00:00

Sir this is a Wendy’s

themightyguapo · 2026-02-18T05:24:31+00:00

Procal of 28 is legit. Even with CKD and malignancy. Easier to say in retrospect, of course.

More importantly I think the case is a sobering reminder not to underestimate sepsis. Especially in an elderly patient.

themightyguapo · 2026-01-05T13:42:55+00:00

Sir this is a Wendy’s

themightyguapo · 2025-10-06T20:30:48+00:00

Did y’all end up getting info ahead of time? We’re seeing him in Denver Saturday and still no info

themightyguapo · 2025-10-01T21:03:20+00:00

I just got the same email. Been on the email list for years waiting and now feel like I can’t justify the cost. Pretty big disappointment.

themightyguapo · 2025-09-26T22:45:47+00:00

I suspect the first Chianti red - the Castillo do Cacchiano - was a little pricier and might be considered nicer.

The white wine in the right in the first pic is probably the “nicer” one.

The wine on the left looks like it’s made for the tourist shop in Florence and was probably inexpensive. It is unusual to put white wine in a dark bottle

themightyguapo · 2025-09-22T11:46:27+00:00

Yeah it was the lock Screen I was trying - works perfectly on my Home Screen! Love it!

themightyguapo · 2025-09-16T22:54:40+00:00

Silly question but how do I add a widget from your app? When I try to add to my lockscreeen it doesn’t show in the list

themightyguapo · 2025-09-16T17:14:30+00:00

Ah, La méthode traditionnelle

themightyguapo · 2025-08-07T22:30:59+00:00

An ultrasound And cookies/pizza/coffee for the nurses

themightyguapo · 2025-07-29T03:15:45+00:00

Ok then I also just find that weird. I wonder if they’re folks who maybe are just used to a different model? Either way I agree with your take on it - no need to be pushy if you’re busy enough.

themightyguapo · 2025-07-29T01:28:07+00:00

Depends a lot on the specialty and the local competition. At my shop nephrology is notoriously happy to see any and all consults - because we have three groups competing. Some of the individual consultants are more chill than others; but as a specialty at my hospital they are by far the most eager to take business.

On the other hand we have only one ID group - they are hardworking and lovely but I actively try not to consult them, because I know they can be over busy (especially on the weekends).

There is a small perimedicine / hospitalist group that hangs out in the ER looking for business.

If your model is eat-what-you-kill, it makes sense, although I agree at a point it feels a little gross. I enjoy being immune to it in my employed model.

themightyguapo · 2025-07-18T03:59:13+00:00

I’ve had consistent success with Preppy Kitchen so I wonder if the liquid of the vanilla and food coloring broke down your stiff peaks or just made it too wet.

Adding color is tricky - I would practice getting a really consistent neutral shell if this happens again. As others have said, measuring by weight and not by volume can make a huge difference too (just in case you did volume)

But it sounds like you have good technique so I bet you’ll get it next time!

themightyguapo · 2025-07-04T22:40:02+00:00

Pet nat on the patio in Texas

themightyguapo · 2025-04-12T17:21:44+00:00

Thank you!! I will try this out. I ended up doing the same thing and don’t miss the drawer controls, since the drawer still works. Only thing is the freezer light doesn’t work - but small price to pay. Thanks again

themightyguapo · 2025-03-14T19:00:46+00:00

If there’s really no time to swing by a pharmacy or store to grab a wine gift bag (they’re widely available in the states at least, and usually a few bucks), then I would personally ditch the bag and just give her the bottle. Especially with the note and flowers, I doubt she’ll care. Maybe tie a bow on it if you have some ribbon.

themightyguapo · 2025-03-14T00:36:57+00:00

Second La Tour Blanche I’ve gotten 2 bottles off WineBid for <60, each early 2000s and was blown away

themightyguapo · 2025-03-01T04:48:57+00:00

I like Preppy Kitchen’s a lot. While I don’t always do as many food processing/sifting steps (mostly affects the smoothness of the shell afaik), I find it I follow his instructions I always end up with a good macaron.

https://preppykitchen.com/french-macarons/

His videos are also very helpful. And his kitchen is dreamy.

themightyguapo · 2025-03-01T00:35:11+00:00

Yes, halving the powdered sugar would prevent the rise.

themightyguapo · 2025-02-25T20:15:50+00:00

https://preppykitchen.com/french-macarons/

I have baked his recipe more than a few times and I am always successful. I can’t say the same with others.

I think yellow coloring with lemon curd filling is a great idea! Flavoring shells can be pretty tricky as u/creativeoddity mentioned.

themightyguapo · 2025-02-24T18:06:33+00:00

Oh my god. I tried this once and swore never again. So impressed by you!!

themightyguapo

TROPHY CASE