Hospital Medicine Unplugged

In this episode of Hospital Medicine Unplugged, we unpack mixed connective tissue disease—recognize the overlap syndrome hiding between lupus, scleroderma, and myositis, and aggressively monitor the pulmonary complications that drive morbidity and mortality. MCTD is defined by high-titer anti-U1 RNP antibodies plus overlapping connective tissue disease features. The hallmark clues: • Raynaud pheno...

In this episode of Hospital Medicine Unplugged, we break down myelodysplastic syndromes—recognize the unexplained cytopenias, understand the modern molecular classification, and risk-stratify patients before progression to AML. The WHO 2022 classification shifted MDS from a purely morphologic disease to a genetically informed diagnosis. New entities include MDS with SF3B1 mutation, isolated del(5q...

In this episode of Hospital Medicine Unplugged, we unpack cardiac amyloidosis—recognize the red flags hiding inside “routine HFpEF,” diagnose ATTR noninvasively, and start disease-modifying therapy before restrictive physiology becomes irreversible. ATTR cardiac amyloidosis is far more common than previously recognized, especially in older adults with HFpEF and increased LV wall thickness. Key clu...

In this episode of Hospital Medicine Unplugged, we tackle sarcoidosis—recognize the classic presentations, screen aggressively for silent organ involvement, and treat the patients at highest risk for irreversible damage or sudden death. Diagnosis requires three things: compatible clinical presentation, non-caseating granulomas, and exclusion of alternative granulomatous disease like TB, fungal inf...

In this episode of Hospital Medicine Unplugged, we unpack autoimmune encephalitis—recognize the red flags early, treat aggressively before antibody results return, and support the long recovery arc that often extends years beyond discharge. We open with the bedside reality: autoimmune encephalitis is frequently missed because it masquerades as psychiatry, infection, toxic-metabolic disease, or une...

In this episode of Hospital Medicine Unplugged, we unpack acute interstitial nephritis (AIN)—a frequently overlooked cause of acute kidney injury (AKI) driven largely by medications, immune reactions, and systemic diseases. We start with epidemiology clinicians should recognize. AIN accounts for roughly 15–27% of kidney biopsies performed for AKI and about 2.8% of all kidney biopsies overall. Amon...

In this episode of Hospital Medicine Unplugged, we break down celiac disease—from epidemiology and modern diagnostic strategies to life-threatening complications and emerging therapies beyond the gluten-free diet. We start with epidemiology clinicians should know. The global prevalence of celiac disease is ~1.4% based on serology and ~0.7% with biopsy confirmation. Incidence rates are ~17 per 100,...

In this episode of Hospital Medicine Unplugged, we tackle polypharmacy and deprescribing—how to recognize problematic medication overload, quantify its harms, and apply structured, patient-centered strategies to safely reduce medication burden. We begin with definitions that shape clinical practice. Polypharmacy is most commonly defined as the use of ≥5 medications, though definitions vary. Import...

In this episode of Hospital Medicine Unplugged, we break down primary hyperparathyroidism (PHPT)—from epidemiology and pathophysiology to modern imaging, surgical indications, and evolving medical therapies. We start with who gets PHPT and how often it occurs. The condition affects ~0.8–0.9% of the general population, with an incidence of 4–6 cases per 10,000 person-years. It is 2.5 times more com...

In this episode of Hospital Medicine Unplugged, we break down ANCA-associated vasculitis (AAV)—granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA), and eosinophilic granulomatosis with polyangiitis (EGPA)—focusing on modern epidemiology, complement-driven pathophysiology, ANCA serotypes, and the rapidly evolving treatment landscape. We start with epidemiology clinicians should r...

In this episode of Hospital Medicine Unplugged, we sprint through fat-soluble vitamins—A, D, E, and K—focusing on how they’re absorbed, why deficiencies happen, and the clinical syndromes hospitalists must recognize early. From intestinal transporters to neurologic deficits and neonatal bleeding, we connect physiology to bedside decision-making. We start with absorption mechanics, which are more c...

In this episode of Hospital Medicine Unplugged, we sprint through thalassemia—an inherited hemoglobinopathy defined by reduced or absent globin chain production, ineffective erythropoiesis, and chronic anemia. We break down the genetics, pathophysiology, clinical spectrum, and why this disorder remains the most common monogenic disease worldwide. We start with the big picture. About 5% of the glob...

In this episode of Hospital Medicine Unplugged, we sprint through ankylosing spondylitis and axial spondyloarthritis—recognize inflammatory back pain early, understand the disease spectrum from non-radiographic to radiographic disease, and treat aggressively to prevent structural damage and disability. We begin with the modern concept of axial spondyloarthritis (axSpA), which represents a disease...

In this episode of Hospital Medicine Unplugged, we sprint through prosthetic heart valves—how to choose between mechanical and bioprosthetic valves, manage anticoagulation safely, recognize complications, and navigate the expanding role of transcatheter valve replacement. We begin with the two major categories of prosthetic valves: mechanical valves and bioprosthetic (tissue) valves. Mechanical va...

In this episode of Hospital Medicine Unplugged, we sprint through asbestosis—understand how inhaled fibers trigger progressive pulmonary fibrosis, recognize key radiographic features, and manage patients with attention to malignancy risk and progressive fibrotic disease. We start with pathophysiology, where the story begins decades before symptoms appear. After inhalation, asbestos fibers deposit...

In this episode of Hospital Medicine Unplugged, we sprint through glomerulonephritis—recognize the nephritic syndrome, decode complement patterns and immunofluorescence clues, and manage diseases ranging from self-limited post-infectious GN to rapidly progressive crescentic disease. We start with the clinical syndrome of glomerulonephritis, defined by glomerular inflammation producing hematuria, h...

In this episode of Hospital Medicine Unplugged, we sprint through thyroid cancer—understand the epidemiologic paradox of rising incidence but stable mortality, stage disease using modern AJCC criteria, apply ATA recurrence risk stratification, and tailor therapy from surgery and radioiodine to targeted molecular treatments. We start with the epidemiology of thyroid carcinoma, the most common endoc...

In this episode of Hospital Medicine Unplugged, we sprint through anaphylaxis—recognize the rapid systemic reaction, understand the mast-cell storm driving shock, and deliver epinephrine immediately to prevent cardiovascular collapse. We begin with the definition and diagnostic framework. Anaphylaxis is a severe, rapid-onset, life-threatening systemic hypersensitivity reaction. When it progresses...

In this episode of Hospital Medicine Unplugged, we sprint through upper motor neuron (UMN) syndromes—how spasticity develops, how to separate true reflex hyperexcitability from fixed stiffness, and how to diagnose and manage major UMN diseases like PLS and hereditary spastic paraplegia. We begin with spasticity, a defining feature of UMN injury that is not simply an immediate “release phenomenon.”...

In this episode of Hospital Medicine Unplugged, we break down endovascular infections—vascular graft infections, mycotic aneurysms, CIED infections, and septic thrombophlebitis syndromes—focusing on modern epidemiology, evolving microbiology, advanced imaging, and high-yield management strategies. We begin with epidemiology clinicians should know. Vascular graft infections occur in ~0.5–6% of vasc...

In this episode of Hospital Medicine Unplugged, we sprint through delirium tremens—the most dangerous stage of alcohol withdrawal—recognize the neurochemical storm, identify high-risk patients, and treat aggressively with benzodiazepines and supportive care to prevent fatal complications. We begin with epidemiology and why DTs matter. Delirium tremens occurs in 3–5% of hospitalized patients with a...

In this episode of Hospital Medicine Unplugged, we sprint through urticaria—recognize the wheal, distinguish acute from chronic disease, uncover autoimmune drivers, and step through a modern treatment ladder that now includes biologics and BTK inhibitors. We start with the definition and epidemiology. Urticaria is characterized by transient pruritic wheals, angioedema, or both, typically resolving...

In this episode of Hospital Medicine Unplugged, we sprint through acute exacerbation of interstitial lung disease (AE-ILD)—recognize the sudden decline, rule out infection and cardiac causes, support oxygenation, and navigate a disease with limited treatment options and high mortality. We begin with the diagnostic framework defined by the 2016 International Working Group. Acute exacerbation is cha...

In this episode of Hospital Medicine Unplugged, we sprint through status epilepticus—stop the seizure fast, escalate therapy on time, protect the brain, and treat the cause before refractory disease sets in. We begin with the modern definition that changed emergency care. Status epilepticus is now defined as ≥5 minutes of continuous seizure activity or ≥2 seizures without return to baseline. The o...

In this episode of Hospital Medicine Unplugged, we sprint through measles—one of the most contagious infectious diseases known—covering transmission, classic clinical presentation, complications, diagnosis, and prevention through vaccination. We start with the big picture. Measles (rubeola) is a highly contagious viral illness caused by a paramyxovirus and remains a major global public health conc...