This week I am rounding for 3 days. Because at least one of my colleagues wanted to read how I used set pieces on rounds, I am planning to highlight some set pieces that I used for each day this week.
1. Pt. with COPD, s/p CABG and sterniotomy infection – admitted with increased dyspnea
Set piece – main reasons that COPD patients present with increased dyspnea – he actually had atelectasis from the pain of his infection
2. Pt. with resolving pneumococcal pneumonia
Set piece – what deaths do antibiotics not prevent? what deaths do antibiotics prevent in pneumococcal pneumonia
Set piece – what a pericardial friction rub sounds like
3. Pt. with hyperparathyroidism
Set piece – indications for parathyroidectomy
Later I did a session for the medical students on stage III CKD. Actually the session is based on several set pieces:
- Stages of CKD
- Why CKD 3-5 patients die prior to developing ESRD
- Metabolic complications of stage 3 or 4 CKD – and how to consider management
- Who gets type IV RTA and why it's a problem
- How to consider normal progression of CKD (1/creat vs time plot)
- How to slow progression of CKD
- Why patients with CKD present with worse renal function
I forgot to discuss planning for renal consultation – I will find the students today and discuss that issue.
Added in the afternoon – I also discussed the causes of pancreatitis and the treatment of hypertriglyceridemia induced pancreatitis.
Please let me know if this is helpful. If anyone wants more information on particular set pieces, just leave a comment.
{ 2 comments… read them below or add one }
Hi
I would ( and many readers) love to read a detailed blog entry on CKD, based on above set pieces.
What is your set piece on parathyroidectomy? I have been a surgical resident in an endocrine unit whose criteria was “if we can”.