Hospital Medicine

Pulmonology   

Questions discussed in this category



Estimating blood loss from hemoptysis is not always reliable. The bleeding may be due to the PE itself. Is anticoagulation with any degree of hemoptys...

Is there a role for oral vancomycin in these patients, or is oral vancomycin redundant if other routes of administration are being used (i.e intracolo...

High-risk PEs are typically treated with loading doses of anticoagulants or bridging with LMWH. Do you omit the bridging/loading period and go straigh...

If they have been on IV heparin for 3 days, for example, would you subtract those days from the recommended loading dose time?

Data on the role of steroids in HIV negative patients with PJP has been conflicting.

Have recent trials (TRAIN trial and HEMOTION trial) influenced your approach? 

Some data showed early enteral nutrition improves outcomes in DKA. Some thought that enteral nutrition could counteract the insulin gtt.

The new SCCM guidelines suggest an upper limit of 200 compared to the conventional 180.

Blood pressure targets for ischemic stroke and intracerebral hemorrhage are described in several guidelines. However, in patients with acute stroke wh...

Assume thrombolytics are not indicated. Do you favor early DOAC transition after 24-48 hours of heparin gtt or do you favor LMWH for 10-14 days follow...

Multiple recent trials have shown higher first pass success rate with VL over DL.

Do the results of the recent study (Misset et al., PMID 37889107) showing reduction in 28-day mortality in patients with high neutralizing antibody ti...

Do you favor gradual reduction in oxygen and pressure support with intermittent medication as needed or immediate extubation with peri-extubation medi...

In the span between the HACA trial and the Targeted Temperature Management in Out-of-Hospital Cardiac Arrest study (Dankiewicz et al., PMID 34133859),...

Is it different than early mobility that we always encourage?

Though there is data to support using both hydrocortisone and fludrocortisone, it seems to be used rarely in clinical practice. A review publishe...

Patient became acutely flushed, developed severe and prolonged hypotension with brief loss of consciousness, dizziness, nausea, dry heaves and headach...

What factors do you consider while deciding between bronchoscopic vs surgical management?

What’s your threshold to get the three AFBs and place the patient in airborne isolation?

Are there any quantitative indices (eg. volume, pleural fluid hematocrit) that would impact your decision to stop subsequent TPA/dornase treatments?

How do you decide between starting infliximab, MMF, or IVIG? If a patient presents in respiratory failure (nearing or requiring intubation), woul...

How do you approach which risk to accept given that steroids have evidence for use in COVID-19 while is suggestion for harm in using steroids in influ...

For instance, if the patient doesn’t tolerate apnea testing, is too unstable to go for ancillary testing outside the ICU, and TCDs/EEG are unava...

Do you use hydrocortisone 200 mg/day as studied in ADRENAL/APROCCHSS or dexamethasone 20 mg/day as studied in DEXA-ARDS?

Given the substantial risks associated with transporting an intubated and ventilated patient to Radiation Oncology, is there any evidence to support t...

Would you discontinue Methotrexate and TNF inhibitors even if previously no side effects from these medications, and would you consider Cyclophosphami...

Would you consider treating the full mediastinum or any mildly enlarged nodes, even contralateral? Do you have a strategy that transitions from a pall...

Would you treat if there is active infection?  How much improvement would you expect?


Papers discussed in this category


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N Engl J Med, 2020 Feb 13

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Radiology, 2012-10

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Crit Care, 2021 Jul 28

Chest, 2010-05

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Journal of critical care, 2011 Jan 26

Chest, 2015-09

J Thorac Dis,

Chest, 1997-01

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BMC Res Notes, 2020 Aug 03

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JAMA cardiology, 2016-09-01

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The New England journal of medicine, 2002-02-21

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JAMA, 2005-10-05

Trials, 2016 Jul 22

N Engl J Med, 2023 Mar 21

Chest, 2020 Aug 11

The Lancet. Respiratory medicine, 2021 Sep 07

American journal of respiratory and critical care medicine, 2020 May 01

Chest, 2018 Jun 30

The European respiratory journal, 2010 Jul 01

Transplantation, 2024 May 23

Journal of hospital medicine, 2019-01

The New England journal of medicine, 2019 Feb 18

Phlebology, 2020 Mar 02

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Journal of vascular surgery, 2000 Nov

The American journal of gastroenterology, 2003 Jun

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The American journal of medicine, 2016-05

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Journal of critical care, 2023 May 13

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JAMA internal medicine, 2023 May 01

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Chest, 2007-10

American journal of respiratory and critical care medicine, 2013-04-01

The European respiratory journal, 2024 May 02

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Annals of the American Thoracic Society, 2024 May

Critical care (London, England), 2021 Aug 31

Neurocritical care, 2005

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JAMA internal medicine, 2018-10-01

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JAMA internal medicine, 2024 May 13

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2018-05-17

JAMA, 2023 Dec 19

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The New England journal of medicine, 2024 Jun 13

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European journal of anaesthesiology, 2015 Dec

The American journal of emergency medicine, 2016 May 28

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Circulation, 2024 Oct 29

Diabetes care, 2024 Aug 01

The New England journal of medicine, 2000-05-04

Respiratory care, 2011-11

JAMA, 2005 Dec 28

Respiratory care, 2011 Oct

The New England journal of medicine, 2013 May 20

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases, 2022 Sep 10

The Lancet. Infectious diseases, 2016 Mar 02

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JAMA, 2024 Dec 09

American journal of respiratory and critical care medicine, 2009-11-01

Stroke, 2015 Oct 29

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JAMA, 2022 May 17

JAMA, 2013 May 22

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The clinical respiratory journal, 2018 Sep

The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation, 2021 Feb 17

Transplantation, 2020 Aug

Kidney Med, 2020 Jan-Feb