Medical Education
Clinical teaching and practical ideas for your next study session.
Normal Bilirubin, Acute Cholecystitis: Choose the Next Test
A normal bilirubin does not make persistent right upper quadrant pain benign. Learn how cystic-duct anatomy, ultrasound, HIDA, CT, MRCP, and ERCP answer different diagnostic questions.
INR 11.2 Without Bleeding: Safe Warfarin Reversal Without Overcorrection
An INR above 10 is a management threshold, not a cue for indiscriminate reversal. Learn how to confirm truly absent bleeding, consider low-dose oral vitamin K, monitor the response, and restart anticoagulation safely.
A Negative IGRA Before Biologic Therapy: When to Reopen the TB Workup
A negative IGRA before biologic or other immunosuppressive therapy lowers the probability of TB infection, but its reassurance depends on exposure timing, immune competence, and the clinical evaluation for TB disease. Learn when to repeat testing, consider a second test, or investigate further.
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.