Screening in ED o/n: How to screen in 1-2min - referral reason - HPI: substrate (function, relevant comorbidities), CC tempo of illness -> severity at 1st medical contact (VS pertinent labs/rads) -> tx(s) and responses - your exam 1/

2/ - provisional dx with key supporting features and focused ddx focused on life-threatening, treatable, and common conditions - dispo (admit vs. not, ward, tele, ICU) w/ comment on anticipated course

In neuro clinic: - role of EEG in seizure is to delineate pattern of epilepsy, prognosticate first time seizure and rule out NCSE - if unprovoked seizure, normal neuroimaging and equivocal EEG, repeat once with sleep-deprived EEG and if nothing don’t tx with AED 1/

2/ - if two unprovoked sz >24h apart, EEG isn’t going to change management so don’t order - it’s possible to get secondary migraines (I.e. AVM associated) so there’s a role for neuroimaging as you may be able to cure it - abn neuroimaging and/or EEG in setting of sz warrant AED

In endo clinic: - think of TGs separately from other lipids: they are fuel for muscle and adipose tissue and travel in blood via chylomicrons - insulin facilitates LPL which allows uptake of TGs into these tissues - insulinopenic states generally have high TGs 1/

2/ - DKA pts generally have high TGs - insulin, fibrates, and lifestyle all can lower TGs - I’ve had two recent cases with acute pancreatitis 2/2 hypertriglyceridemia that both responded beautifully to IV insulin #MedEd #FOAMed