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Clinic numbers Virginia Mason Franciscan Health™ Travis Gerrard MD Internal Medi
cine p 206-583-2299 f 206-223-6764 1100 9th AVE C8 GIM Seattle, WA 98101 vmfh.org
Good site to see kidney failure risk https://kidneyfailurerisk.com
Venous insufficiency: why legs swell and feel heavy Venous insufficiency happens
when the veins in the legs have trouble moving blood back up toward the heart. Healthy vein valves act like one-way doors. When those valves become weak or dama…
For a patient with osteoporosis who completed 5 years of alendronate with benefi
t and is now 2 years into a bisphosphonate holiday, a DXA scan is recommended now or within the next year, as guidelines recommend reassessing fracture risk and…
Seattle Area - Outside + VMFH Non-Oncology Infusion Centers: North End: Infusion
Solutions (Bellingham, Everett, Federal Way, Tacoma) Infusion for Health (Montlake Terrace, Bellevue) South End PURE Infusions (Olympia, Kirkland, Spokane, Taco…
Yes, treating strep throat with antibiotics at 72 hours is still worthwhile when
there is a newborn in the household, primarily to reduce transmission risk to the vulnerable infant, even though the symptomatic benefit to the adult is modest …
GLP‑1 RAs vs SGLT2i on (Micro)albuminuria In type 2 diabetes with kidney involve
ment, both GLP‑1 receptor agonists (GLP‑1 RAs) and SGLT2 inhibitors (SGLT2i) improve albuminuria, but their relative strength and focus differ across studies. O…
Cholesterol guidelines website Site I built to help guide next steps https://tra
visgerrard.github.io/cholesterol/
Naps: Good vs.
Bad and Rules for Effective Napping Source: Eric Topal's Ground Truths, "A Master Class on Sleep" with Professor Yo-El Ju Good Nappers vs. Bad Nappers People ge…
Frozen Shoulder vs.
Rotator Cuff Tendinopathy A comparison of two common causes of shoulder pain and dysfunction, differing in etiology, clinical presentation, examination findings…
Halitosis: A Multifactorial Condition This case serves as a textbook example of
why halitosis is often labeled a "multifactorial" condition. Even when a primary systemic cause (like H. pylori) is addressed, the lingering symptoms frequently…
2026 ACC/AHA Guideline on Management of Dyslipidemia Seen with resident — Source
: ACC.org, published JACC March 13, 2026 Full title: 2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Dyslipidemia Replace…
Osteoporosis in Postmenopausal Women: Monitoring Initial Therapy with Oral Bisph
osphonates UpToDate algorithm — reviewed with resident Initial Steps Counsel on adherence to bisphosphonates, vitamin D, and calcium Educate on secondary causes…
Pathophysiology: Primary vs Secondary Hypogonadism Primary Hypogonadism (Testicu
lar Failure — Hypergonadotropic) Caused by disease of the testes → decreased testosterone and sperm production Pituitary responds by increasing LH and FSH ("hyp…
How to Measure Testosterone Initial Test Morning fasting total testosterone — dr
awn between 8–10 AM Ideally measured by LC-MS/MS (liquid chromatography-tandem mass spectrometry) in a certified lab Do not test during acute illness — transien…
When to Check Testosterone in Middle-Aged Males The Core Rule: Symptoms First, A
lways Do not check testosterone in asymptomatic males — regardless of comorbidities or risk factors. Population screening is not recommended. Test when clinical…
Topical Corticosteroid Potency Guide Topical steroids are classified into 7 pote
ncy groups (group 1 = super-high, group 7 = least potent). Vehicle matters — ointments are more potent than creams of the same drug. Go-To Agents by Tier | Tier…
Dermatomes Map A dermatome is an area of skin supplied by a single spinal nerve.
This body map shows the dermatome distribution across anterior and posterior surfaces. Source: Healthline — Dermatomes Explained and Located
Olecranon Bursitis: Compression + NSAIDs vs Aspiration Mild compression combined
with NSAIDs is a reasonable conservative approach for nonseptic olecranon bursitis, with resolution rates comparable to aspiration or steroid injection (approxi…
CKD Screening & Diagnosis — WCHQ Toolkit Source: WCHQ CKD Screening & Diagnosis
Toolkit Who to Screen Screen early and frequently for patients with: Type 2 diabetes Hypertension Age > 60 Obesity Family history of kidney disease History of a…
