Clinical Problem Solving

For this Grand Rounds, we have another Clinical Problem Solving (CPS) case to allow listeners to watch in real time how master clinicians reason through challenging cases. While getting the diagnosis “right” is amazing to see, 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).
Our discussant will be Rabih Geha, MD, assistant professor of Medicine at the SFVAHCS. Rabih is the director of education for the VA Emergency Department rotation overseeing the education of Psychiatry, Emergency Medicine and Internal Medicine residents. Clinically, he splits his time between the emergency room and the inpatient teaching wards. Rabih is also the co-founder of the Clinical Problem Solvers, a multimodal medical education venture run by a diverse and global team that hosts a weekly podcast (Dx reasoning, Anti-Racism, Women in Medicine, Queer Rounds), live virtual morning report, and other medical education content.
Key teaching points based on the case preparation by Parnassus Chief Residents Anna Fretz, MD, MHS, and Viridiana Garcia, MD, MS, will follow the discussion along with a review by our mystery experts.
Note: Closed captions will be available within 48-72 hours after posting.
Program
Bob Wachter: Introduction
00:02:14-00:44:30 - Rabih Geha, MD (assistant professor of Medicine, SFVAHCS)
00:44:45-01:00:55 - Discussion with Annabel Frank, MD (clinical fellow, Division of Hematology and Oncology at UCSF Health), Nirav Bhakta, MD, PhD (associate professor of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine at UCSF Health)
See previous Medical Grand Rounds:
• March 16: Innovations and Controversy: Updates in Geriatrics
• Innovations and Contro...
• March 9: Stroke 2023: A Change Has Come and Is Still Coming
• Stroke 2023: A Change ...
• March 2: A Fireside Chat with Eric Topol
• A Fireside Chat with E...
• February 23: Protecting the Legitimacy of Medical Expertise: Combating Misinformation in Medicine
• Protecting the Legitim...
See all UCSF Covid-19 grand rounds, which have been viewed over 3M times, at • UCSF Department of Med... .

[@jonb8166]

Great discussion. EGPA has a former name which the speaker did not want to mention, but it had nothing to do with Nazis. Churg and Strauss were both Jewish immigrants from Europe who described this syndrome while working at Mt Sinai Hospital in New York. The old eponym was abandoned as part of the elimination of eponyms for a group of related disorders, including a different one, which had been named for a Nazi physician.

[@AshutoshUpadhyayaisgeeky]

I would refrain from using eponym when we have a name that is self descriptive. But Ganalomatosis with polyangitis is probably the one speaker was referring to . Anyways I don't think I completely understood why EGPA was not the diagnosis here specially when it can also be antibody negative. Can it be ruled out winout the tissue diagnosis? Great discussion though. I have been a regular viewer of clinical problem solver and I enjoy learning the art of clinical reasoning from the team.