Medicine Library
Clinical medicine, explained through reasoning.
A short internal-medicine shelf. Original writing. Drug doses and numeric cutoffs are left out until a current source is checked for that sentence.
Cardiology
Approach to chest pain
Chest pain is common. A few causes kill quickly, and they do not all look like a heart attack.
Cardiology
Acute coronary syndromes
A coronary plaque event is a time-sensitive diagnosis. The first ECG changes what happens next.
Cardiology
Heart failure
Breathlessness has many causes. Heart failure is a syndrome of congestion, perfusion, or both — not a single drug list.
Cardiology
Atrial fibrillation
The ECG label is the easy part. The decision is whether the patient is unstable, and what the rhythm means for stroke risk later.
Respiratory
Pulmonary embolism
Clot in the lung is easy to under-call in a stable patient and easy to over-treat in the wrong patient.
Respiratory
Asthma and COPD exacerbations
Wheeze is a sound, not a diagnosis. The dangerous asthmatic patient may have almost no wheeze.
Infectious diseases
Sepsis and septic shock
Infection plus organ dysfunction is a different problem from a fever in a well person.
Endocrinology
Diabetic emergencies
High glucose is not one disease. Ketones and consciousness change the emergency.
Nephrology
Potassium disorders
Potassium kills by changing the cardiac membrane, and the serum number is not the whole story.
Nephrology
Acute kidney injury
A rising creatinine is a description. The useful question is pre-renal, intrinsic, or obstruction.
Gastroenterology
Upper and lower gastrointestinal bleeding
The color of the blood matters less than whether the patient is shocked.
Neurology
Stroke and TIA for the physician
A sudden focal deficit is a vascular emergency until hemorrhage is excluded. Time language changes between protocols, so this page does not print a minute cutoff.
12 chapters in this shelf. This is not an encyclopedia.