Welcome to The Pearl Log — where post-shift wisdom surfaces, one shiny clinical take at a time. Some pearls are fresh, some are rough, all are found under pressure.
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Potpourri: Euglycemic DKA, Slit Lamp, Abd Pain in Pregnancy
A few quick takeaways from shift. Euglycemic DKA is real—new ADA criteria now allow for normoglycemia if ketones and acidosis are present. Think alcohol, SGLT2s, or pregnancy. Brush up on some slit lamp basics. And for early pregnancy with pain or bleeding, grab the probe first. If you find an IUP, congrats, then your basically done.
The Beta-HCG and Ectopic Pregnancy. Myth-Busting.
You can’t rule out an ectopic pregnancy with a low or “reassuring” β-hCG. The discriminatory zone only applies to normal intrauterine pregnancies, not ectopics—and many ruptures occur with levels well below 1,500 mIU/mL. Every symptomatic pregnant patient needs an ultrasound, regardless of hCG value. No hCG cutoff, and no pattern of symptoms, safely excludes an ectopic.