Date Time: MS3 Progress Note (medicine) S: Interval history? Pain? Appetite? NOW THINK: what is happening with my patient? Anything special I need to think about/look for on exam? Anything I don’t understand about what is happening with them? O: VS: Tm I/O: Tc P R BP Sat on Gen: HEENT: Lungs: C/V: Abd: Extremities: Neuro: Antibiotics? Pain meds? DVT prophylaxis? Diet: Labs: Cultures Imaging A/P Day of GI prophylaxis? Fluids? Rate? Hypercalcemia Etiologies - CHIMPANZEES C - Calcium overdose (don’t usually mention this one) H - Hyperparathyroidism, Hyperthyroidism, Hypothyroidism, familial Hypercalcemic hypocalciuria I - Immobility M - Multiple myeloma P – Paget’s disease A – Addison’s disease N – Neoplasms: - metastasis to bones and - hypercalcemia of malignancy (a paraneoplastic syndrome) Z – Zollinger-Ellison syndrome E – Excess vitamin A E – Excess vitamin D S – Sarcoidosis Indications for Acute Hemodialysis - AEIOU A – Acidosis (unable to be managed medically) E – Electrolytes (typically hyperkalemia, unable to be managed medically) I – Intoxication (methanol, ethylene glycol, lithium) O – Overload (fluid overload unresponsive to diuretics) U – Uremia (symptomatic) Causes of delirium – MOVE, STUPID Metabolic Oxygen Vascular Endocrine/Electrolyte Seizures Tumor/Trauma/Temperature Uremia Psychogenic Infection/Intoxication Drugs/Degenerative disease Causes of metabolic acidosis with an anion gap – MUD PILES M – methanol U – uremia D – diabetic ketoacidosis P – para-aldehyde I – Isoniazid, iron, inborn errors in metabolism L – lactic acidosis E – ethanol, ethylene glycol S – salicylates Treatment of Acute MI – MONA M - morphine O - oxygen N - nitrates A - aspirin