Clinical Pearls from the ACP IM Conference in 2018

My first foray into this form of sharing knowledge from conferences. If you are interested in doing the same, a few tips:

  1. String tweets, it’s easier to read and understand the context

  2. Try to rewrite the speaker’s point in simple language that can be understood if read on its own

  3. Look for a reference to include so that you and others can fact check the statement

  4. If you are reading someone else’s tweet about a medical fact, and you disagree, try responding with specific evidence. Don’t ask someone else to do all the work. In other words, rather than saying “prove it to me” say, “here’s my interpretation of this linked study, what do you think?”

  5. If you tag people, do it at the end, so they are not tagged in every tweet.

Clinical Pearls

  1. Culture most abscesses, especially if ivdu or they happened underwater (and you have to get in a deep pocket for it to be useful).

  2. Antibiotics may be useful even in simple abscess, but this is still debatable

  3. Moral injury (aka burnout) is twice as likely in women physicians and probably linked to systemic sexism and apathy toward women in medicine

    (Wherein I met Mark LInzer and did not know I was in the presence of greatness)

  4. The prevalence of sleep apnea is probably between 9 and 17% (Peppard 2013)

  5. You don’t need to stop anticoagulation for cataract surgery anymore than you need to stop it for a haircut.

  6. Oil content of Ointment>cream>lotion so start with ointment for dry areas

  7. Structured exercise and beta blockers are both reasonable treatments for POTS but exercise has more impact on quality of life

  8. Being a weekend warrior is still better for lifespan than being a couch potato so get your Saturday morning sweat on

  9. Weight loss, smoking cessation and side sleeping are better than cpap for mild OSA.

  10. Sleep deprivation (not having enough time to sleep) is bad for your health. But insomnia (lying awake in bed) has not been shown to have the same risks. So take it easy on the sleeping pills and fitbits guys.

  11. Related: Sleeping pills are more dangerous than insomnia. Make every effort to avoid and deprescribe.

  12. Exercise anytime of the day is better than no exercise for insomnia, so scrap the within 2 hours of bedtime rec!

  13. Pentoxifylline plus compression stockings is best for treating venous stasis ulcers.

  14. 90% of ANA tests are false positive. Order cmp, CBC, esr, crp first to see if there are systemic signs before ordering ANA.

  15. Focusing on pain in fibromyalgia and other central disorders gets patients into an endless cycle of ineffective pills. Shift your focus and patient’s focus to function and co-occurring stressors.

  16. Tai chi may be the most effective treatment for fibromyalgia