Internal Medicine blog
Clinical teaching and practical ideas for your next study session.
When Wheeze Is Not Just COPD: Sorting HFpEF From Mixed Acute Dyspnea
An older smoker with wheezing, hypoxemia, orthopnea, and edema may have concurrent COPD exacerbation and acute heart failure. This case discussion shows how to identify the dominant physiology, interpret BNP and ABG findings, and treat both safely.
Wells Score for Pulmonary Embolism: The Point-Scoring Traps That Change D-Dimer vs CTPA
A Wells score is only useful when every point is earned. Learn how to assess DVT signs, immobility, and clinical judgment accurately, then choose D-dimer, CTPA, or V/Q imaging.
Modified Wells Score for Pulmonary Embolism: Score Precisely, Then Choose CTPA
A high Wells score should move the clinician toward definitive imaging—not reflexive D-dimer testing. Work through the score carefully, identify common traps, and choose the correct next test.
Suspected NSTE-ACS in CKD: A High-Stakes Diagnostic and Management Case
When diabetes, chronic kidney disease, dynamic ECG changes, and troponin elevation collide, the key is to recognize high-risk NSTE-ACS without under-treating or over-anticoagulating the patient.