Family Medicine notes

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🆕 Vitamin D for the Prevention of Disease: An Endocrine Society Clinical Practice Guideline 🔷 Empiric vitamin D is recommended for: ✅ 1 - 18 y/o 👦🏻 ✅ >75 y/o 👴🏻 ✅ pregnant🤰 ✅ high-risk pre-DM 🔷 General adult population 18 - 75 y/o ❌ NO routine vitamin D testing ❌ NO empiric vitamin D Tx 🔗 https://academic.oup.com/jcem/advance-article/doi/10.1210/clinem/dgae290/7685305?login=false

RBBB 🆚 LBBB 🚨 remember: new LBBB w/ chest pain = MI, until proven otherwise

Answer: ✅ meningococcal rash (meningococcemia)

Spot diagnosis? Hint: sick child with fever

🆕 FLOW trial Effects of Semaglutide on CKD patients with T2DM

Just released today! 🆕 ACC/AHA Guidelines for Lower Extremities PAD 🔗 https://www.ahajournals.org/doi/10.1161/CIR.0000000000001251?utm_campaign=sciencenews23-24&utm_source=science-news&utm_medium=phd-link&utm_content=phd-05-14-24&

👶🏻 Confusing Neonatal jaundice: 💛 Physiological jaundice: (2-5 d) resolves w/i 2 wks (no dehydration) 🤱🏻 Breastfeeding FAILURE jaundice (BFJ): is EXACERBATING physiological jaundice → usually in the 1st wk of life + baby DEHYDRATION 🥛 BreastMILK jaundice (BMJ): >1 wk of life (peaks at 2nd wk)

Today May 7th is the #World_Asthma_day GINA have released their 🆕 asthma guidelines 2024 🔗 https://ginasthma.org/2024-report/

✴️ Aortic Stenosis (AS) 🟢 mild • Aortic Valve Area: 1.5 - 2 cm², or • Mean gradient: <20 mmHg • Peak velocity: 2-3 m/s 🟡 Moderate • Aortic Valve Area: 1-1.5 cm2, or • Mean gradient: 20-39 mmHg • Peak velocity: 3-4 m/s 🔴 Severe • Aortic Valve Area: <1 cm², • Mean gradient: ≥ 40 mmHg, or • Peak velocity: ≥4 m/s • ✅ Tx: if SYMPTOMATIC → IMMEDIATE replacement, otherwise regular f/u 🚨 Critical: • Aortic Valve Area: <0.8 cm², or • Mean gradient: ≥ 50 mmHg • ✅ Tx: *IMMEDIATE* valve replacement, usually symptomatic 📝 Assess for symptoms by stress testing, then treat accordingly

It’s official now! USPSTF recommends screening for breast cancer to be started at age 40

Botulism

Leiomyomas (fibroids) 🆚 Adenomyosis 🆚 Polyps 🆚 Endometriosis Adenomyosis → 🔑 boggy (more flaccid than expected) + symmetrical

Spot diagnosis? Hint: 😳