Let's pool our brain power!!!!

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I've been getting my butt kicked on internal medicine by a gunning med student rotating w/ me. I seriously need to step it up and impress my attending so I don't become the "C" med student on the team. So, I figured, why doesn't everybody on here post a good paper idea that relates to common problems in the hospital? Then we'd all have pool of good papers to choose from for bringing in and impressing our teams.

I'll get started with the first one: A paper about the utitility of using Brain Naturietic Peptide to distinguish b/w respiratory and CV causes's of Chest Pain.

Anybody else have some good ideas??

 

[Kalel]

BNP is a good presentation topic. Just remember that the higher it gets, the more specific it gets for heart failure. If it's only in the hundreds, it can still be a laundry list of conditions. There are some interesting (though not earth shattering) updates on BNP in this month's NEJM. I'd reccomend that you subscribe to a few medical journals by e-mail. Then, you can be really "up to date" and maybe bring up topics that your attending and resident hadn't even heard about. Abstracts at the NEJM are free, you get JAMA by joining AMA (cheap as a student), and you can sign up to get ACP and annals newsletters too.
http://www.annals.org/subscriptions/etoc.shtml
http://www.acponline.org/weekly/?hp
http://www.nejm.org

Also, remember not to be too pushy about presenting stuff. If the attending and resident are busy, you aren't going to score points by insisting that you present recent literature during rounds. You should bring the paper there and ask if they'd like to hear about it. Remember that enthusiam in making them believe that you'd like to pick up more patients and you are genuinely interested in learning stuff goes a long way too. Be sure to read ckent's IM FAQ in the IM forum about rotation advise too.

 

[huktonfonix]

If you work hard and take care of your patients well I think and hope it will be rewarded over someone who is gunning and kissing ass. Regardless I think there is some literature regarding Vasopressin vs Epi for PEA or asystole (its already recommended for Vtach/Fib). I think it will be standard ACLS protocol in a couple of years. Can't remember which or the name of the article though. Might be good for ICU rounds.

 

[Bobblehead]

Answer a specific clinical question. For example, in a 36 yo man presenting with chest pain and a UDS positive for cocaine what is the recommended work up for said chest pain?

No one wants to hear the latest NEJM paper post-call, most of the residents probably have their own subscription. A 5 minute focused discussion of how to properly manage a patient could earn you some recognition for your work however.

 

[Gauss]

unless you have a research oriented team/attending they will not be overly impressed and may even be bored by this

case presentations either from NEJM or other source are far more interesting as well as a review of guidelines - like going over American College Gastro guidelines for treatment of GERD
useful things like that

I simply scutted my ass off
never underestimate the ability of scut work to make you look like a star

 

[DrQuinn]

Originally posted by Bobblehead
Answer a specific clinical question. For example, in a 36 yo man presenting with chest pain and a UDS positive for cocaine what is the recommended work up for said chest pain?

Same as everyone else with chest pain. Remember that benzodiazepines are the DOC for cocaine induced chest pain (I've seen ST segments crumble with 2 mg of Ativan). Also remember not to use Beta-Blockers.

Q, DO

 

[DrQuinn]

Originally posted by huktonfonix
If you work hard and take care of your patients well I think and hope it will be rewarded over someone who is gunning and kissing ass. Regardless I think there is some literature regarding Vasopressin vs Epi for PEA or asystole (its already recommended for Vtach/Fib). I think it will be standard ACLS protocol in a couple of years. Can't remember which or the name of the article though. Might be good for ICU rounds.

The study you're referring to was in the January 8th 2004 of NEJM... "A Comparison of Vasopressin and Epinephrine for Out-of-Hospital Cardiopulmonary Resuscitation."

Several issues with that article, but you should discover them on your own. It is a long ways away from being put in the ACLS guidelines, as this was a post-hoc analysis, and the 95% CI was 0.1 - 1.0, but nevertheless I'm more willing to use VP for PEA and Asystole anyways... since there's nothing to lose.

Q, DO