The Inaugural Hollander Rounds: Clinical Problem Solving with Brad Sharpe

We are pleased to announce that our quarterly Clinical Problem Solving series will be renamed “Hollander Rounds,” to celebrate our former Internal Medicine Residency Program Director Harry Hollander, MD. A Clinical Problem Solving case allows listeners to watch in real time how master clinicians reason through challenging cases. While getting the diagnosis “right” is impressive, the true learning comes from witnessing how experts navigate the zigs and zags of a diagnostic journey in a case that unfurls in real time (as it does in life, of course). 
Speaker
Brad Sharpe, MD, is professor of Clinical Medicine and a clinician-educator in the Division of Hospital Medicine at UCSF Health. He has held multiple leadership roles at UCSF, most recently as the prior chief of the Division of Hospital Medicine at UCSF Health. He previously served as the associate program director for Inpatient Affairs for the UCSF Internal Medicine Residency.
Key teaching points based on the case preparation by Parnassus Chief Residents Tyrone Johnson, MD and Madison Malone, MD will follow the discussion.
Note: Closed captions will be available within 48-72 hours after posting.
Program
Bob Wachter: Introduction
00:05:30-00:47:25 - Hollander Rounds with Brad Sharpe, MD, professor of Clinical Medicine and a clinician-educator in the Division of Hospital Medicine at UCSF Health
00:47:50-00:54:50 - Daniel Minter, MD, assistant professor of Medicine in the Division of Infectious Diseases
00:55:00-01:03:00 - Anne Kjemtrup, DVM, MPVM, PhD, veterinarian research scientist at the California Department of Health
01:03:25-1:05:33 - Closing remarks
See previous Medical Grand Rounds:
• September 14: Loneliness and Social Isolation Among Older Adults: The Role of Clinicians
• Loneliness and Social ...
• September 7: Summer Covid-19 Update
• Summer Covid-19 Update
• June 29: The Final Covid-19 Grand Rounds: What Have We Learned? • The Final Covid-19 Gra...
• June 22: A Fireside Chat with Lindsey Criswell, Director of NIAMS • A Fireside Chat with L...
See all UCSF Covid-19 grand rounds, which have been viewed over 3M times, at • UCSF Department of Med... .

[@user-ed9vh9vm2i]

I love clinical medicine. This case discussion is so insightful. We'll be doing the same here in Africa

[@RahulKumar-gy2iy]

Very interesting presentation!

[@NickMackenzieMD]

Minor point, Salinas is in the Salinas Valley, not the Central Valley. I am aware of a case of cocci in Monterey County some 45 years ago during a large wind event which blew dust into the Salinas Valley. Would be interesting to know where she spent the night in Tahoe. Finally, would retained products of conception be on the differential diagnosis early in the workup phase?

[@stephanielush9471]

Excellent and interesting presentation. Thank you.

[@jaca18md]

Was the diagnosis made by blood test? How long after the pt recovered was the diagnosis made?

[@jonb8166]

The diagnostic test result appears momentarily on the screen at 48:02. I am not sure why they didn't discuss it. I was presented a very similar case with the same dx a few years ago in "stump the chump" rounds, and this is a very challenging disease to diagnose. I had the benefit of a more detailed and helpful history than was given in this case.

[@jaca18md]

@@jonb8166 Kudos to the person who ordered that test. In my experience, it's not in the usual panel of studies recommended by ID. We had a similar case at LA County about 15 years ago where the actual diagnosis was not in anyone's differential, but blood cultures grew Yersinia pestis.

[@patriciahoke4722]

Surprised not to see a glucose. Surprised not to hear anything about any kind of covid test (unless they just knew it was not covid). First or second thought of mine - retained product of pregnancy. Probably way off base esp after 5 months.