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Banner Good Samaritan/Phoenix VA Medical Center

   Internal Medicine Programs

 

  An Educational Innovations Project Program

 

 
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Welcome to the Banner Good Samaritan Medical Center Internal Medicine Residency Program website.

 

Another week has flown by & you are still doing GREAT! Sit down for a second and reflect on all the things you’ve learned this week. Here are some shared learning points from the VA, BGS and IMC:

 

· Inpatient diabetes management: calculate TDD (in units of insulin)—> use 50% as long acting and the other 50% as short acting divided TID w/meals. Even when NPO, we all need basal (even Joe Orme!!).

· Aortic stenosis & GIB —> think Heyde’s syndrome! Remember the mecha-nism is related to disruption of vwf multimers from shearing forces when moving through the stenotic aortic valve.

· Consider checking legionella urinary antigen in patients with CAP.

· Diverticul-OSIS causes painless rectal bleeding & diverticul-ITIS presents with LLQ pain and fever—not typically with BRBPR (bright red blood per rectum).

· Tension pneumo —> needle decompression... where?...Midclavicular line, 2nd intercostal space, ABOVE the rib.

· When treating patients with a DVT, think about when a CT angio is really necessary—will knowing whether a patient has a non-hemodynamically signifi-cant PE change your management?

 

It’s was a fun week, as always thanks for all your hard work!

 

Your chiefs,

Amanda, Bisi, Leigh Anne and Monica