My favorite genre of medical humor is preventable catastrophe. Someone in my recent flumazenil thread described it as “brainbros hate this one trick,” and I (IM doc) have been entertaining myself on my commute ever since by compiling a list of other things we all hate. A few contenders: - Haldol in PD: Patient has a dopamine deficiency. Have we considered making it worse? - Dilt in pre-excited AF: An accessory pathway! Let’s make sure all the traffic uses it. - Steroids before biopsy in suspected primary CNS lymphoma: We need a tissue diagnosis. Have we considered dissolving the evidence first? - Continuing an SGLT2i thru surgery: DKA is so much easier to recognize when the glucose is 500. Let’s make it euglycemic and keep everyone guessing. - High-dose steroids in unrecognized Strongyloides: The parasite’s been quietly living in the intestine for twenty years. Let’s give it the opportunity to travel. No one has a monopoly on this particular flavor of suffering. What are the orders, medication combinations, or baffling clinical decisions that make YOUR specialty say “oh, for fuck’s sake”? Extra points for catastrophes with particularly elegant pathophysiology. Also the tox people in my last thread actually taught me things, so apparently this counts as CME.   submitted by   /u/adrsaurusrex [link]   [comments]