II. Updates: July 2025
-
Pericardial Effusion (cv, Pericardium)
- Updates
-
Superior Vena Cava Obstruction (cv, vessel)
- Updates
-
Skin Infections in Diabetes Mellitus (derm, endo)
- Updates
-
Knuckle Pad (derm, hyperplasia)
- Added
-
Vesicle (derm, exam)
- Updates - Corrected misspelling of Vesicle in many entries
-
Adrenal Insufficiency (endo, adrenal)
- Updates
-
Short Stature (endo, growth)
- Updates
-
Tall Stature (endo, growth)
- Updates
-
Hand Foot and Mouth Disease (ent, mouth)
- Updates
-
Herpangina (ent, mouth)
- Updates
-
Boric Acid Toxicity (er, toxin)
- Updates
-
Giardia (gi, id)
- Updates
-
Cryptosporidium (gi, id)
- Updates
-
Entamoeba histolytica (gi, Diarrhea)
- Updates
-
Endometrial Cancer (gyn, hemeonc)
- Updates
-
Tumor Lysis Syndrome (hemeonc, pharm)
- Updates
-
Immune Effector Cell-Associated Neurotoxicity Syndrome (hemeonc, pharm)
- Added
-
Apheresis (hemeonc, procedure)
- Added, along with related definitions
-
Oncologic Emergency (hemeonc, sx)
- Updates
-
Neutropenic Fever (id, hemeonc)
- Updates
-
Adenovirus (id, virus)
- Updates
-
Arbovirus (id, virus)
- Updates
-
Arenaviridae (id, virus)
- Added
-
Astrovirus (id, virus)
- Added
-
Bunyaviridae (id, virus)
- Added
-
Coxsackie Virus B (id, virus)
- Added
-
Filovirus (id, virus)
- Added
-
Flaviviridae (id, virus)
- Added
-
Papovaviridae (id, virus)
- Added
-
Picornaviridae (id, virus)
- Added
-
Poxviridae (id, virus)
- Added
-
Norovirus (id, virus)
- Updates
-
Rabies (id, virus)
- Updates
-
Reoviridae (id, virus)
- Added
-
Rotavirus (id, virus)
- Updates
-
Smallpox (id, virus)
- Updates
-
Togaviridae (id, virus)
- Added
-
Chronic Granulomatous Encephalitis (neuro, id)
- Added
-
Primary Amebic Meningoencephalitis (neuro, id)
- Updates
-
Anti-Amyloid Beta Plaque Monoclonal Antibody (neuro, pharm)
- Updates
-
Epidural Neoplasm (ortho, hemeonc)
- Updates
-
Hand Infection (ortho, id)
- Updates
-
Hypercalcemia of Malignancy (renal, hemeonc)
- Updates
-
SIADH (renal, Sodium)
- Updates
-
Acute Monoarthritis (rheum, joint)
- Updates
-
Chronic Opioid (rheum, pain)
- Updates
-
Pigmented Villonodular Synovitis (rheum, hemeonc)
- Added
-
Nocturia (urology, sx)
- Updates
III. Updates: June 2025
-
Right Bundle Branch Block (cv, ekg)
- Updates
-
Internal Hernia (endo, surgery)
- Updates
-
PECARN Pediatric Intra-Abdominal Injury Algorithm (er, exam)
- Updates
-
Tracheal Suction (er, procedure)
- Updates
-
Political Protest Injury (er, Trauma)
- Added
-
Conducted Energy Weapon (er, Trauma)
- Added
-
Kinetic Impact Projectile Injury (er, Trauma)
- Added
-
Riot Control Agent (er, Trauma)
- Updates
-
Concussion (er, neuro)
- Updates regarding TBI lab markers
-
Hepatitis B
Virus (gi, liver)
- Updates to HBV, Hepatitis B Serology and Hepatitis B Carrier
-
Oncogene (hemeonc, id)
- Added
-
PFAS Chemical (hemeonc, prevent)
- Added
-
Sickle Cell Crisis (hemeonc, sickle)
- Corrections on Reticulocyte Count (thanks to Dr. Mark Khalil)
-
Upper GI Bleed (gi, sx)
- Updates related to children
-
Lower GI Bleed (gi, sx)
- Updates related to children
-
Postmenopause (gyn, endo)
- Updates
-
Female Sexual Dysfunction (gyn, psych)
- Updates
-
HTLV1 (hiv, exam)
- Added
-
HIV Pathophysiology (hiv, exam)
- Extensive Updates
-
HIV Staging (hiv, exam)
- Updates
-
HIV Labs (hiv, lab)
- Updates
-
HIV Postexposure Prophylaxis (hiv, prevent)
- Biktarvy is now preferred as single tablet once daily for 28 days
-
Sepsis (id, fever)
- Updates on Esmolol in the prevention of septic Cardiomyopathy related to persistent Sinus Tachycardia
-
Vaccine (id, immunize)
- Updates
-
Herpesviridae (id, virus)
- Updates
-
Herpes Simplex Virus (id, virus)
- Updates
-
Venous Blood Sampling (lab, hemeonc)
- Updates
-
Obstructive Sleep Apnea in Children (lung, peds)
- Updates
-
Dementia (neuro, cognitive)
- Updates
-
Migraine Headache Prophylaxis (neuro, Headache)
- Updates
-
Trigeminal Neuralgia (neuro, Headache)
- Updates
-
Lamotrigine Toxicity (neuro, pharm)
- Updates
-
Cordyceps (pharm, alternative)
- Updates
-
Naloxone (pharm, Analgesic)
- Updates
-
Ketorolac (pharm, Analgesic)
- Updates
-
Pediatric Analgesic (pharm, peds)
- Updates
-
Radial Head Fracture (ortho, elbow)
- Updates
-
Rib Fracture (ortho, lung)
- Updates
-
Xylazine Toxicity (psych, cd)
- Updates
-
Zuranolone (psych, pharm)
- Updates
-
Juvenile Idiopathic Arthritis (rheum, peds)
- Updates
-
Occupational Injury (sports, work)
- Updates
-
Digital Block (surgery, Anesthesia)
- Updates
IV. Updates: May 2025
-
Accelerated Junctional Tachycardia (cv, ekg)
- Updates
-
Chromoblastomycosis (derm, Fungus)
- Added
-
Erythrasma (derm, Bacteria)
- Updates
-
Tirzepatide (endo, pharm)
- Updates regarding OSA indication
-
Hourly Subcutaneous Insulin (endo, pharm)
- Updates
-
Laryngeal Fracture (ent, Larynx)
- Updates
-
Traumatic Brain Injury (er, neuro)
- Updated mild, moderate and severe brain injury with their associated BIG 1, 2, 3 criteria
-
Rectal Drug Delivery Route (er, pharm)
- Added
-
Open Angle Glaucoma (eye, Glaucoma)
- Updates to medications
-
Lateral Canthotomy (eye, procedure)
- Updates
-
Eosinophilic Esophagitis (gi, Esophagus)
- Updates
-
Hepatic Encephalopathy (gi, neuro)
- Updates
-
Premenstrual Syndrome (gyn, psych)
- Updates
-
Cutaneous B-cell Lymphoma (hemeonc, lymph)
- Added
-
Antiplatelet Therapy for Vascular Disease (hemeonc, pharm)
- Updates
-
Fungal Infection (id, Fungus)
- Added
-
Mucormycosis (id, Fungus)
- Added
-
Candidiasis (id, Fungus)
- Updates
-
Tetracyclines (id, pharm)
- Updates regarding safety in pregnancy, Lactation and children
-
Influenza (id, virus)
- Updates
-
Measles (id, virus)
- Updates
-
Metapneumovirus (id, virus)
- Added
-
Parainfluenza VIrus (id, virus)
- Added
-
Paramyxovirus (id, virus)
- Added
-
COPD Exacerbation Antibiotics (lung, copd)
- Updates
- Thanks to Dr. Mark Khalil for email feedback
-
Aspergillosis (lung, Fungus)
- Updates
-
AI Virtual Scribe (manage, computer)
- Added
-
Acute Migraine Headache (neuro, Headache)
- Updates
-
Unintended Pregnancy (ob, antepartum)
- Updates
-
RhoGAM (ob, pharm)
- RhoGAM is NOT required for Miscarriage or abortion <12 weeks gestation per ACOG 2024
- However, RhoGAM is still recommended in Ectopic Pregnancy <12 weeks or when dates are uncertain
-
Ginkgo Biloba (pharm, alternative)
- Updates
-
Topical Fluoride (pharm, minerals)
- Updates
-
Food Dye (pharm, nutrition)
- Added
-
Opioid Use Disorder (psych, cd)
- Updates
-
Psychosis (psych, Psychosis)
- Updates
-
Groin Injuries in Athletes (ortho, sx)
- Updates
-
Nursemaid's Elbow (ortho, elbow)
- Hyperpronation technique is most effective reduction (more evidence)
-
Cervical Spine Imaging in Acute Traumatic Injury (ortho, rad)
- Updates
-
Ginseng (pharm, alternative)
- Updates
-
Urinary Catheterization (urology, procedure)
- Updates
V. Updates: April 2025
-
Oral Mucosa Hyperpigmentation (derm, pigment)
- Updates
-
GLP1 Agonist (endo, pharm)
- Updates regarding gastrointestinal effects and Malnutrition risk
-
Insulinoma (endo, Hypoglycemia)
- Updates
-
Mastoiditis (ent, ear)
- Updates on Antibiotic management
-
Epistaxis (ent, nose)
- Updates with TXA related evidence
-
Hypothermia (er, environ)
- Updates regarding progressive EKG changes
-
Cardiopulmonary Resuscitation (er, exam)
- Updates regarding pulse checks
-
Trichloroethylene Poisoning (er, toxin)
- Added
-
Radiation Exposure (er, weapon)
- Updates
-
Central Retinal Artery Occlusion (eye, cv)
- Updates
-
Barrett Esophagus Cancer Risk Score (gi, exam)
- Added
-
Alcoholic Liver Disease (gi, liver)
- Updates
-
Bacterial Vaginosis (gyn, id)
- Updated with refractory/recurrence co-treatment of male sexual partner with Flagyl oral and Clindamycin Topical
- Thank you to Nate D for bringing a new article from NEJM to my attention
-
Chronic Pelvic Pain (gyn, sx)
- Updates
-
Paraneoplastic Syndrome (hemeonc, endo)
- Added
-
Sickle Cell Disease (hemeonc, Hemoglobin)
- Extensive updates including adding several subtopics
-
Blood Culture (id, lab)
- Updates
-
Mycobacteria (id, Bacteria)
- Updates
-
Mycoplasma (id, Bacteria)
- Updates to Mycoplasma pneumonia and Ureaplasma Urealyticum
-
Leprosy (id, Bacteria)
- Updates, including adding Clofazimine
-
Syphilis Serology (id, lab)
- Extensive updates including Treponemal Specific Test, Non-Treponemal Test and Dark-field Microscopy
-
Anti-Ribosomal Antibiotic (id, pharm)
- Updates to Macrolides, Tetracyclines, Aminoglycosides and other Anti-Ribosomal Antibiotics
-
Beta Lactams (id, pharm)
- Updates to Penicillins, Cephalosporins, Carbapenems and Aztreonam
-
Travel Preparation (id, travel)
- Updates to this and various related topics
-
Rabies (id, virus)
- Updates
-
Enzyme Activity (lab, exam)
- Added enzyme type image
-
Clofazimine (lung, pharm)
- Added
-
Acute Bronchitis (lung, rhonchi)
- Updates
-
Susceptible Tuberculosis Treatment (lung, tb)
- Updates to this and Active Tuberculosis related to the shorter 4 month course with Moxifloxacin
-
Down Syndrome (neuro, Disability)
- Updates
- Temporal Artery Biopsy (neuro, eye)
- Updates regarding Ultrasound
-
Vertebral Osteomyelitis (ortho, id)
- Updates
-
Wrist XRay (ortho, rad)
- Added Lateral XRay image
-
Pectoralis Major Muscle Rupture (ortho, Shoulder)
- Added
-
Pacifier (peds, behavior)
- Updates
-
Kratom (pharm, alternative)
- Added
-
Suzetrigine (pharm, Analgesic)
- Added
-
Medication Patch (pharm, metabolism)
- Updates
-
Religious Fasting During Ramadan (pharm, nutrition)
- Updates
-
Trauma Informed Care (psych, anxiety)
- Added
-
Lithium Toxicity (psych, pharm)
- Updates
-
Prevention of Kidney Disease Progression (renal, prevent)
- Incorporated KDIGO 2024 recommendations
-
Interscalene Block (surgery, pharm)
- Updates
VI. Updates: March 2025
-
Atrial Fibrillation (cv, ekg)
- Updates
-
Mobitz II AV Block (cv, ekg)
- Updates
-
Vagal Maneuver (cv, procedure)
- Updates
-
POTS Syndrome (cv, exam)
- Updates regarding aerobic Exercise in its management
-
Genital Wart (derm, wart)
- Updates
-
Cat Scratch Disease (er, bite)
- Updates
-
Gastric Cancer (gi, hemeonc)
- Extensive updates
-
Helicobacter Pylori (gi, id)
- Updated H. pylori treatment again based on ACG 2024
-
Bowel Preparation (gi, procedure)
- Updates
-
Menorrhagia (gyn, Menses)
- Updates
-
Enoxaparin (hemeonc, pharm)
- Updates
-
Acinetobacter Baumannii (id, Bacteria)
- Added aerobic gram negative Nosocomial Infection
-
Brucellosis (id, Bacteria)
- Updates
-
Burkholderia Cepacia (id, Bacteria)
- Added aerobic gram negative Nosocomial Infection
-
Chlamydiaceae (id, Bacteria)
- Updates including to Trachoma, Inclusion Conjunctivitis, Chlamydial Urethritis, Psittacosis, TWAR
-
Pseudomonas Aeruginosa (id, Bacteria)
- Added
-
Q Fever (id, Bacteria)
- Updates
-
Rickettsiae (id, Bacteria)
- Updates to this and the associated diseases
-
Stenotrophomonas Maltophilia (id, Bacteria)
- Added aerobic gram negative Nosocomial Infection
-
Trench Fever (id, Bacteria)
- Added
-
Haemophilus Influenzae (id, Bacteria)
- Added, and updated Haemophilus Influenzae Pneumonia, Hib Vaccine
-
Yersinia Pestis (id, Bacteria)
- Updates
-
Francisella Tularensis (id, vector)
- Updates
-
Bordetella Pertussis (lung, Bacteria)
- Updates
-
Legionella (lung, Bacteria)
- Updates
-
First Seizure Evaluation (neuro, Seizure)
- Updates
-
Status Epilepticus (neuro, Seizure)
- Updates
-
Growth Plate (ortho, anatomy)
- Updates
-
Plantar Fasciitis (ortho, foot)
- Updates
-
Epiphyseal Fracture (ortho, Fracture)
- Updates
-
Acute Osteomyelitis
- Updates (ortho, id)
-
Pediatric Leg Disorder (ortho, peds)
- Extensive updates including related topics (Intoeing, Out-toeing, Genu Valgum, Genu Varum)
-
Toxic Synovitis (ortho, peds)
- Updates
-
Sudden Infant Death Syndrome (peds, er)
- Updates
-
Alpha Lipoic Acid (pharm, alternative)
- Added
- Not recommended in Diabetic Neuropathy due to low efficacy
-
Refractory Depression Management (psych, depression)
- Psilocybin is slightly better than Placebo in Major Depression
-
Metabolic Acidosis (renal, acidbase)
- Updates
-
Metabolic Alkalosis (renal, acidbase)
- Updates
-
Arterial Blood Gas Interpretation (renal, lab)
- Updates
-
Suprapubic Bladder Aspiration (urology, procedure)
- Added
-
Phimosis (urology, penis)
- Updates regarding Topical Corticosteroid protocol
VII. Updates: February 2025
-
QTc Prolongation (cv, exam, ekg)
- Updates
-
Myocardial Infarction with Nonobstructive Coronary Arteries (cv, cad)
- Added
-
Cardiac Amyloidosis (cv, Myocardium)
- Added
-
Electrocardiogram in Children (cv, peds)
- Added
-
Clonidine Overdose (cv, pharm)
- Updates for the related Imidazoline Poisoning
-
Vasopressin (cv, pharm)
- Updates
-
Oral Health in Children (dental, prevent)
- Updates
-
Acute Sinusitis (ent, sinus)
- Updates
-
Copper Poisoning (er, toxin)
- Added
-
Seat Belt Sign (er, Trauma)
- Updates
-
Acute Vision Loss (eye, sx)
- Updates
-
Campylobacter jejuni (gi, id)
- Updates
-
Vibrio Cholerae (gi, id)
- Updates
-
Vibrio parahaemolyticus (gi, id)
- Added
-
Yersinia enterocolitica (gi, id)
- Updates
-
Pediatric Reflux (gi, peds)
- Updates
-
Sickle Cell Anemia (hemeonc, Hemoglobin)
- Updates to various associated topics
-
CVA Thrombolysis (hemeonc, pharm)
- TNK has low efficacy in minor stroke and is associated with increased CNS Hemorrhage risk
-
Andexxa (hemeonc, pharm)
- Updates on efficacy (does not alter patient-oriented outcomes and higher thrombosis risk)
-
Gram Negative Bacteria (id, Bacteria)
- Updates
-
Enterobacter (id, Bacteria)
- Added
-
Escherichia coli (id, Bacteria)
- Updates
-
Klebsiella Pneumoniae (id, Bacteria)
- Added
-
Proteus Mirabilis (id, Bacteria)
- Added
-
Salmonella (id, Bacteria)
- Updates
-
Serratia Marcescens (id, Bacteria)
- Added
-
Shigella (id, Bacteria)
- Updates
-
Yersinia Pestis (id, Bacteria)
- Updates
-
Meningococcal Vaccine (id, immunize)
- Updates
-
Sulopenem Etzadroxil and Probenecid (id, pharm)
- Added
-
Neisseria gonorrhoeae (id, std)
- Updates
-
Social Generation Category (manage, communication)
- Added
-
Meningococcal Meningitis (neuro, id)
- Updates
-
Carbidopa-Levodopa (neuro, pharm)
- Updates
-
Luxatio Erecta (ortho, Shoulder)
- Updates
-
Picky Eating (peds, behavior)
- Updates
-
Thumb Sucking (peds, behavior)
- Updates
-
Hyperimmune Bovine Colostrum (pharm, alternative)
- Added
-
Pediatric Insomnia (psych, peds, sleep)
- Updates
-
Factitious Disorder (psych, somatic)
- Updates
-
Dysuria (urology, sx)
- Updates
VIII. Updates: January 2025
-
Left Ventricular Outflow Obstruction (cv, chf)
- Updates
-
Pediatric Hypertension (cv, peds)
- Updates
-
Aprocitentan (cv, pharm)
- Added this Endothelin Receptor Antagonist, limited fourth line agent for Refractory Hypertension
- Requires REMS program enrollment to prescribe (Teratogenic)
-
Endothelin Receptor Antagonist (cv, pharm)
- Added this class used primarily for Pulmonary Arterial Hypertension
-
Exercise Stress Test (cv, procedure)
- Updated various stress tests
-
Subungual Melanoma (derm, hemeonc)
- Updates
-
Keloid (derm, hyperplasia)
- Updates to Keloid and Hypertrophic Scar
-
Cutaneous Sporotrichosis (derm, id)
- Updates
-
GLP-1 Agonist (endo, pharm)
- Added equivalent dosing for GLP-1 Agonists (to aid switching between agents)
-
Cardiopulmonary Resuscitation (er, exam)
- Updates regarding Pediatric Resuscitation
-
Listeria monocytogenes (gi, id)
- Updates
-
Liver Function Test Abnormality (gi, lab)
- Updates to this and related topics
-
Stress Ulcer (gi, pud)
- Updates regarding prophylaxis indications (need more than Mechanical Ventilation alone)
-
Premenstrual Disorder (gyn, psych)
- Updates
-
Direct Oral Anticoagulant Score (hemeonc, exam)
- Added
-
Sickle Cell Anemia (hemeonc, hgb)
- Updates regarding Penicillin prophylaxis
-
Pediatric Anemia (hemeonc, peds)
- Updates
-
Anthrax (id, Bacteria)
- Updates
-
Bacillus Cereus (id, Bacteria)
- Added
-
Coryneform Bacteria (id, Bacteria)
- Added
-
Corynebacterium diphtheriae (id, Bacteria)
- Updates
- Clostridium (id, Bacteria)
-
Rhodococcus equi (id, Bacteria)
- Added
-
Streptococcus (id, Bacteria)
- Updates to Streptococcus, Group A Streptococcus, Group B Streptococcus
- Added Streptococcus Viridans Group
-
Staphylococcus (id, Bacteria)
- Updates to Staphylococcus Aureus and MRSA
- Added Staphylococcus Epidermidis, Staphylococcus Saprophyticus
-
Pneumococcal Conjugate Vaccine (id, immunize)
- Significant updates that simplify overall Pneumococcal Vaccine protocols
- All adults age 50 years and older are now vaccinated with 1 dose of PCV20 or PCV21
- Immunocompromised Adults age 18 to 50 years are also vaccinated with PCV20 or PCV21
- Children are still vaccinated with Primary Series with PCV20 until PCV21 is approved
-
Quinine Toxicity (id, pharm)
- Added
-
Advanced Airway in Children (lung, procedure)
- Updated failed airway in age <8 years: surgical Tracheostomy vs Needle Cricothyrotomy
-
Cerebral Intraparenchymal Hemorrhage (neuro, cv)
- Updates
-
Subarachnoid Hemorrhage (neuro, cv)
- Updates
-
Duke Abdominal Assessment Scale (nicu, exam)
- Added as part of NEC evaluation
-
Stress Fracture (ortho, Fracture)
- Updates
-
Reverse Total Shoulder Arthroplasty (ortho, surgery)
- Updates
-
Peppermint Oil (pharm, alternative)
- Updates
-
Alcohol Withdrawal (psych, cd)
- Updates
-
Septic Joint (rheum, id)
- Updates
-
Pediatric Abdominal Pain (surgery, peds)
- Updates
-
Priapism (urology, penis)
- Correction in Phenylephrine preparation, thanks to Nick Yarbrough, Emergency PharmD