Carlos Rubiano, MD
@carlosrubiano
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Hospitalist| UNC Internal Medicine Graduate| @FSUCoM MED Alum | @FGCU Alum |Views are my own.
Joined July 2009
RT @uncimchiefs: Protégete a ti y a los demás. Nosotros nos vacunamos, y invitamos a nuestra comunidad hacer los mismo. #VacunateNC http….
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One more case remains! Check out our case series so far! @hdx @uncimchiefs.
#MedTwitter it's Day 4 of @UNCDeptMedicine #morningreport! Be sure to solve these cases by @efinnamazing @carlosrubiano @AnnKumfer if you haven't already!. #MedEd #MedStudentTwitter #FOAMed #diagnosis.
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Oculomasticatory myorhythmia!.
2/One of my favorite diseases is Whipple's disease. I have created a summary infographic. While a rare diagnosis (about 1/1 mil), I believe with increased PCR testing more cases with be discovered that have been misdiagnosed.
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AGA guidelines recommend against the use of prophylactic abcx use in severe and mild pancreatitis.
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Pts with acute biliary pancreatitis should undergo early surgical eval/cholecystectomy (i.e. on admission rather than dc.) Early surgery was associated with reduction in mortality and gallstone related complications.
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My Article Take home points:.Early oral feeding as tolerated within 24 hours of diagnosis helps prevent complications. Specifically, it can help prevent translocation of bacteria and thus infected peripancreatic necrosis. PO>>> NGT>> avoid TPN.
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Correct answer is to encourage PO intake. Question inspired from the following article: review of the acute pancreatitis mgmt. Chaitoff A, Cifu AS, Niforatos JD. Initial Management of Acute Pancreatitis. JAMA. 2020;323(22):2331–2332. doi:10.1001/jama.2020.2177.
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RUQ ultrasound is pending. Aside from fluids and supportive mgmt, of the following what is the most appropriate next step in mgmt.?.
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Good morning! Daily board review q! middle aged man p/w several days of worsening epigastric pain, nausea and emesis. ROS negative. No hx Etoh use. Exam VSS. Mild epigastric tenderness w/o guarding or rigidity. Pertinent Labs: Lipase 5x ULN. Slight leukocytosis.
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I also have to highlight this great figure from the article which has a good schema for a therapeutic approach to psoriasis.
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Though all (behavioral, environmental, genetic and medication risk) can contribute to the development of psoriasis, Genetic risk factors seem to be the greatest (one estimate from the article says it can be as high as 40% in individuals with parents who are both affected).
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Thank you everyone for participating, strong work! This question to came to mind when reviewing the following: Armstrong, A. W., & Read, C. (2020). Pathophysiology, Clinical Presentation, and Treatment of Psoriasis. Jama, 323(19), 1945. doi: 10.1001/jama.2020.4006.
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I pledge to continue opposing racism & hate. To set aside my implied right to silence, inaction, and comfort, and act to leverage my privilege to make a difference. Join me by nominating 5 others: . #BlackLivesMatter @skyazim @BenDeMarcoMD1 @MARichmanMD @efinnamazing @SebasOBaq.
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Which risk factor likely contributed most to her development of psoriasis?.
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Currently treated with topical corticosteroids. Social history remarkable active smoking and EtoH use. Family hx notable for psoriasis.
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Good Monday all! quick #boardreview #medEd 29 yo Caucasian female p/f routine follow up to clinic. She has a hx of well controlled plaque psoriasis localized to her knees and elbows.
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Zhu CY, Sturgeon C, Yeh MW. Diagnosis and Management of Primary Hyperparathyroidism. JAMA.2020;323(12):1186–1187. doi:10.1001/jama.2020.0538.
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This pt has evidence of primary hyperparathyroidism (PHPT) indicated by incr Ca and PTH. Her presentation of symptomatic nephrolithiasis and age <50 are two indications for operative mgmt. of PHPT. Answer A. Check out this great schema from a recent JAMA article to learn more.
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