Nephrology & Physician Advocacy Friday School—10/4/2019

We had a terrific Friday school this afternoon! First a panel of patients who had undergone renal transplant shared their experiences with our residents, facilitated by transplant nephrologist Dr. Mita Shah. Next, Residents worked through advanced cases of Acute Kidney Injury with Dr. Tyler Woodell, while Interns talked through Acute Kidney Injury with Dr. Scott Mullaney.

Finally, UCSD Med/Peds 2019 graduate Dr. Grant Meyer, Med/Peds R2 Dr. Nicky Herrick, and UCSD GIM (4th & Lewis) attending Dr. Julie Sierra spoke to us about the important role physicians can play in Advocacy efforts.

Women in Medicine & Wellness: Paint Night with Cathy Cichon!

Tonight, we had our last Women in Medicine event of the academic year. It was a PAINT NIGHT with Cathy Cichon. (If you haven’t seen her work, check out her instagram).       The picture was based on Rosalind Franklin, who is the OG Woman Scientist. Her work was central to understanding the structure of DNA. Watson and Crick wouldn’t have been able to do it without her. So now…MANY years later, we are giving credit where credit is due and honoring her with our paintings. See you again at the start of the next academic year. You are in good hands with the new leader of Women in Medicine, Chief Medical Resident Kim Chau!

MTC: Cushing’s Syndrome

Happy April Fools Day! But today, we weren’t joking around with an excellent case presentation by one of our amazing med-peds PGY4’s, Dr. Hannah Wangberg! We were extremely lucky to have Dr. Nai-Wen Chi, one of our favorite endocrinologists, as our expert discussant! Dr. Wangberg presented a case of a patient who presented with stress and anxiety, with physical exam suggestive of Cushing’s Syndrome. Remember, Cushing’s Syndrome is the clinical syndrome cause by excess cortisol of ANY cause. This can be ACTH-dependent, ACTH-independent, or come from exogenous steroid use. There are 3 tests that can be done to confirm Cushing’s Syndrome, and you need to have two of the three to confirm: Late-night salivary cortisol 24-hour urine cortisol Low-dose dexamethasone suppression test (you are looking for inability to suppress cortisol) Once Cushing’s Syndrome has been confirmed, the next test is to check ACTH levels – this helps to determine if it is ACTH dependent or independent! We finished the case

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Med/Peds Residents Spread Holiday Joy!

From Dr. Lori Wan, Med/Peds Program Director: Happy Holidays, everyone!  Just wanted to spread some holiday cheer from our Med/Peds Residents. Besides having fun decorating holiday cookies, the real fun thing was collecting generous donations from the med/peds residents for the Marine Toys for Tots.  These toys will help bring the joy of the holiday season and send a message of hope to America’s less fortunate children. Wishing you peace and joy, Lori

Kudos to Pooja–NMPRA Grant winner!

We are very proud of Dr. Pooja Jaeel, not only for doing a great job leading her VA wards team this month but also for landing a National Med-Peds Residents’ Association (NMPRA) Quality Improvement grant! Her project will focus on the transition of care for patients as they move from pediatrics to adult Internal Medicine. This is a vital step and can be quite difficult and stressful for many people to navigate. We are very excited to watch this project grow over the new few years. Thanks to Pooja and the entire Med-Peds team for helping your patients during this unique period in their lives!  

CVC Chief Rounds: STEMI with VSD (with shout-out!)

We had our monthly chief rounds with Dr. Mahmud today at the CVC with Dr. Luke Webster presenting. Our case was a patient who initially presented to an outside facility with an anterior STEMI, received lytics, and was transferred to us for higher level of care and potential PCI. We reviewed reasons for immediate PCI after receiving lytics: persistent chest pain or no improvement in ST elevation of ≥ 50%. The presence of an accelerated idioventricular rhythm is reassuring and suggestive of reperfusion. Here is an example of an accelerated idioventricular rhythm: When the patient arrived, chest pain and ST elevations had already resolved, and so no emergent PCI was performed. However, the patient later developed acute chest pain, new ST elevations in anterior leads, and a new 3/6 holosystolic murmur, and was taken emergently to the cath lab. Given the new murmur, concern was for VSD vs. acute MR in the setting of papillary muscle rupture. There was a 90%

read more CVC Chief Rounds: STEMI with VSD (with shout-out!)