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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Diverticula and Dislocations (Shoulder)
Antibiotics aren’t always required for uncomplicated diverticulitis—per the DINAMO trial, selected immunocompetent patients did just as well without them.
For shoulder dislocations, keep ultrasound in your back pocket—it’s fast for diagnosis and reduction confirmation. Have a few techniques ready (Cunningham, FARES, traction-countertraction). No single trick works every time.
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.