1. If an old person comes in with nausea/vomiting that occurs right after eating and altered mental status, consider dehydration secondary to bowel obstruction.
2. Surgery is contraindicated in people with extensive PEs, both because of anti coagulation concerns as well as cardio-pulmonary function concerns.
3. Liver resections are very, very bloody.
4. Daptomycin covers VRE and MRSA. Enterococcus faecalis is sometimes susceptible to ampicillin.
5. There are at least three ways to remove a large DVT:

1. Clamp the vessel, cut it open, pull out the clot. It's fast and efficient, but causes endothelial damage that often results in the clot re-forming. 
2. Put in a balloon catheter, inflate it distal to the clot, drag out the clot. This procedure is still done, but also causes some endothelial damage. 
3. Put in a catheter, dump TPA on the clot to break it apart. Keep the catheter in, run TPA continuously (+/- heparin to prevent more clots) and then go to the OR for daily angiograms to monitor the progress of the clot and/or dump more TPA on it. 

6. Hypercoagulable state + pleural effusion + ascites + pelvic mass -> think ovarian cancer.
7. The formula for maintenance fluids for someone that weighs over 20 kg is weight in kilos + 40= ml/hour infusion.
8. Differential for sinus tachycardia:

1. psychological: pain, anxiety, panic 
2. blood: anemia, dehydration, DVT, decreased peripheral resistance (vasodilation, AV fistulas, end organ failure). Intravascular fluid depletion (look for falling blood counts), third spacing. (Look for edema, effusions, ascites.)
3. pulmonary: hypoxia from PE/chronic lung dx, 
4. cardiac: SVT, arrhythmia, MI 
5. infection/fever
6. toxic: stimulant drugs, withdrawal from depressants, mercury
7. endocrine: pheochromocytoma, hyperthyroid.

9. If someone comes in with a fever and an obvious wound infection, and you drain/debride the infection, and they are still spiking fevers after 24 hours of powerful broad-spectrum antibiotics, look for another source of infection.
10.  If you're going to give lasix to treat volume overload or edema, watch out for the patient's kidneys.