Neurology exerpts and experts
We have a patient on the consult service who was in a car accident. Actually, he wrecked his car into a pool. He was down for at least 10 minutes. Then he was found to have a ruptured aorta.
He is still alive. Vented, but responsive and as appropriate as one can be on a vent. How is he still alive?
We also have a patient with a bilirubin of 37.9. Nobody knows why. He is hi-lighter yellow. How is he still alive? Does that require a biliblanket? Exchange transfusion?
*****
I am doing my Neurology consults rotation at the large University Hospital, which specializes in very sick patients, and very odd cases. The patients that have syndromes that you memorized in medical school, but have never seen in real life, they end up here. For example, two patients on my list are being worked up for serotonin syndrome. We were consulted on a guy who has Pneumocephalus from picking at his VP shunt. Basically if no one else knows what's wrong with the patients, they come to this hospital.
Or if they need a transplant. This hospital is known for transplants--pancreas, kidney, pancreas and kidney, small bowel, and especially liver. Hence the yellow patients.
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I had a neurology attending who I knew did research in vertigo. In the course of rounds one day, he mentioned using low-dose Neurontin as a third line treatment for dizziness. The next lull in the conversation, I asked what his first and second line treatments were. His answer? "Well, I wrote a textbook on it, so I can't really give you a concise answer."
Later on, we used Up To Date to further research dizziness. Yup, the same attending wrote the article.
He is still alive. Vented, but responsive and as appropriate as one can be on a vent. How is he still alive?
We also have a patient with a bilirubin of 37.9. Nobody knows why. He is hi-lighter yellow. How is he still alive? Does that require a biliblanket? Exchange transfusion?
*****
I am doing my Neurology consults rotation at the large University Hospital, which specializes in very sick patients, and very odd cases. The patients that have syndromes that you memorized in medical school, but have never seen in real life, they end up here. For example, two patients on my list are being worked up for serotonin syndrome. We were consulted on a guy who has Pneumocephalus from picking at his VP shunt. Basically if no one else knows what's wrong with the patients, they come to this hospital.
Or if they need a transplant. This hospital is known for transplants--pancreas, kidney, pancreas and kidney, small bowel, and especially liver. Hence the yellow patients.
*****
I had a neurology attending who I knew did research in vertigo. In the course of rounds one day, he mentioned using low-dose Neurontin as a third line treatment for dizziness. The next lull in the conversation, I asked what his first and second line treatments were. His answer? "Well, I wrote a textbook on it, so I can't really give you a concise answer."
Later on, we used Up To Date to further research dizziness. Yup, the same attending wrote the article.