General Hospital Medicine   

Are there situations in which you still feel comfortable giving IV iron? If not, do you consider PO iron?

For example, anticoagulation for recent, significant PE or dual antiplatelet therapy for recent MI, but requiring urgent procedures such as biopsy of ...

McCreary et al., PMID 37310038

Is there an absolute cutoff for AST/ALT that you use where the risks outweigh the potential harm reduction benefits of using the medication? &nbs...

Do you prescribe it universally or based on specific risk factors?

Especially if Watchman is an option, which would still require temporary anticoagulation post-procedure.

Is there an advantage between saline and LR?

Young adult male previously without bleeding diathesis and no family history. Platelet count, PT, and PTT are normal. Also normal factor 8, 9, 12, 7, ...

Do you still find urinalysis helpful in this situation, or do you rely on more specific culture data, imaging studies, etc.?

What factors might drive decisions for different SSRIs and/or doses?

Do you involve additional specialists, such as ENT, to further evaluate? Is there a particular algorithm followed by your institution, or is it just d...

Given the unprovoked nature, do you favor indefinite anticoagulation? Would a presentation with bilateral distal DVTs or other concerns for thrombophi...

For example, do you consider "cautious" IV fluids or otherwise consider early vasopressors?

Rahman et al., PMID 38224592

For example, do you target K >4 and Mg >2?

If it's reasonable to stop anticoagulation, how frequently should patients be monitored for AFib/atrial arrhythmia recurrence?

In what patient populations would you consider using disulfiram (Antabuse) instead of, or in addition to, acamprosate or naltrexone? In your experienc...

Klementova et al., PMID 40795115

Rogers & Rice, PMID 38018162

How do you critically assess the evidence base for functional medicine approaches? How do you respond when patients specifically request functional me...

Assume QTc is not prolonged, electrolytes are reasonably normal, and the patient is not already on heavy psychotropic polypharmacy.

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

Would you initiate both medications at the same time?

For example, what do you do when someone requests aggressive, life-prolonging treatments but then is not receptive to elements of day-to-day care in t...

When do you have consider sending them as part of your initial workup?

Do you prefer anticoagulation? Is there a role for aspirin? How strongly do you recommend line removal?

In particular, how do you reconcile situations where lung POCUS findings contradict other components of volume assessment (e.g. JVD, peripheral edema,...

Tabaja et al., PMID 38635420

Do you commonly use prognostic tools such as PRESS to aid in your decision?

Are there situations in which you would continue the possible offending agent with close monitoring?

Do you find them more helpful as predictors of perioperative risk or as a baseline to detect post-operative adverse cardiac events?

For example, do you find trending WBC, procalcitonin, CRP, etc., more or less helpful?

What situations prompt you to prescribe dexamethasone to complete a 10-day course at discharge?

If these patients were already prescribed non-selective beta blockers outpatient, do you recommend withholding these medications in the acute phase?&n...

What additional assessments and considerations would you suggest to comprehensively evaluate the underlying cause of the rhythm disturbance and ensure...

Mahé et al., PMID 40162636

Would you be comfortable with the use of DOACs?

Do you extend the course of fidaxomicin past initial 10 days to at least 3-7 days after completion of antibiotics?

Do you use the traditional strict limit of 1.5 L, or do you consider removing more volume if a patient appears to tolerate it?

For example, would you consider alternatives to paracentesis (Denver shunt placement, CART therapy, or permanent tunneled catheters) that might better...

Primary care providers often check iron studies during workup for fatigue, even if anemia is not present. 

What non-pharmacological interventions do you recommend? Do you routinely prescribe prophylactic laxatives to patients initiating opioids? How do you ...

Such as a patient who cannot tolerate oral iron and has had a anaphylaxis to intravenous iron