🔷 When to refer DM patient to a nephrologist?
• eGFR <30
• Urine Alb/Cr ratio >300 mg/d (nephrotic range albuminuria)
• Rapid decline ↓ in eGFR >3 mL/min/1.73 m2 per year
• Inflammatory kidney disease (eg, hematuria and/or sterile pyuria)
• If the cause of the kidney disease is unclear
• Difficult-to-manage complications of CKD (eg, HYPERkalemia, anemia)

Here is a lot of lesions to comment on, however, I meant to refer to hypopyon sign

DDx:
Pemphigus vulgaris
Bullous impetigo

Females with recurrent post-coital cystitis (UTI) should have Single dose Abx immediately after intercourse:

💊 Nitrofurantoin 100 mg (also preferred in penicillin allergy)
💊 TMP-SMX 80mg/400 mg
💊 Cephalexin 250 mg

Spot diagnosis?

✅ Flail chest

© @ingPocilgasx on twitter

🔷 Most acute rhinosinusitis are due to VIRAL 🦠 infections (aka antibiotics are NOT indicated)

🔷 When to suspect BACTERIAL rhinosinusitis?
🤒 Fever and symptom >10 days
🦷 Maxillary toothache
⤵️ Initial symptom improvement and then worsening of symptoms
👃 Cacosmia (sense of bad odor in the nose)
💥 Unilateral facial pain

📣 DM neuropathy can be painFUL or painLESS!

that’s why every DM patient should be EXAMINED for neuropathy by 10g monofilament, at least annually