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Immune-Related Adverse Events of Immune Checkpoint Inhibitors
Immune-related adverse events (irAEs) are toxicities that arise after the administration of monoclonal antibodies targeting immune checkpoints (immune checkpoint inhibitors [ICIs]) in patients with cancer. They can occur at any time after initiation of ICI treatment, with a broad clinical phenotype that can be organ-specific or systemic. Although most irAEs manifest as mild to moderate signs and symptoms, severe forms of irAEs can lead to irreversible organ failure and have acute life-threatening presentations. Treatment should be tailored to the specific organ involved and the severity.
Immune Checkpoint Inhibitor Adverse Events 2.0: 5 Pearls Segment
Although internal medicine providers are familiar with checkpoint inhibitors and their immune-related adverse events (IRAE), there is a gap in the knowledge of specific characteristics of these drugs. They are clinically relevant because their adverse events can present similar to other medical conditions and a high degree of suspicion is needed to identify IRAEs.
ILD and High-Risk Medication Prescribing: Gray Matters Segment
Many clinicians lack familiarity with the diagnostic nuances and management strategies for interstitial lung disease (ILD), particularly in distinguishing subtypes (e.g., UIP vs. NSIP) and selecting appropriate treatment options, such as antifibrotics for fibrosing ILDs and avoiding immunosuppressants in idiopathic pulmonary fibrosis (IPF). Additionally, gaps exist in recognizing the role of multidisciplinary care and addressing social determinants of health to improve outcomes.
Hyponatremia Correction: How Fast Is Too Fast?
In this episode of Annals On Call, Dr. Centor discusses hyponatremia correction rates with Dr. Dustin Mark.First, listen to the podcast. After listening, ACP members can take the CME/MOC quiz for free.
Hyponatremia
Hyponatremia is the most common electrolyte disorder in hospitalized patients. Hospital-associated hyponatremia includes community-acquired (e.g., hyponatremia on admission) and hospital-acquired hyponatremia. Acute-onset hyponatremia requires rapid treatment with hypertonic saline to decrease cerebral edema. In cases of chronic hyponatremia (>48 hours), the brain has time to normalize cell volume by losing solutes. However, even mild chronic cases can have adverse outcomes, such as decreased cognition, osteoporosis, increased risk for falls, and fractures.
Hypomagnesemia and Hypophosphatemia: 5 Pearls Segment
Hypomagnesemia and hypophosphatemia, often overlooked, are prevalent electrolyte disorders, affecting around 5-10% of hospitalized patients. Magnesium acts as a vital cofactor for multiple enzymes and helps regulate calcium and potassium levels, while phosphate is integral to various metabolic and signaling cellular processes. Depletion of these elements correlates with multiple symptoms and adverse outcomes. The rapid identification, diagnosis, and management from internists are crucial for optimal results across different medical settings.
Hypokalemia & Potassium Repletion: 5 Pearls Segment
Hypokalemia is one of the most frequent and significant electrolyte disorders. As the main ion that determines the electrochemical gradient of cells, potassium plays a central role in almost all cellular processes.
Hypertension
Updated U.S. and international hypertension guidelines reflect new studies and analyses that support changes in hypertension management. The 2025 U.S. guideline for prevention, detection, evaluation, and management of high blood pressure (BP) recommends lower BP targets, greater use of out-of-office BP for diagnosis and medication titration, and a different approach to severe hypertension presenting without acute or evolving cardiovascular disease symptoms or signs. New treatments for resistant hypertension are recommended.
Signs of Human Trafficking and Response: A Physician's Guide | ACP
Human trafficking is a widespread issue so physicians need to know signs of human trafficking and treatment. Learn about recognizing and responding to survivors with this course.
How Would You Treat Tricuspid Valve Infective Endocarditis in a Patient Who Uses Injection Drugs? Grand Rounds Discussion From Beth Israel Deaconess Medical Center
Infective endocarditis is a common and morbid condition involving prolonged hospital stays, significant disability, and a high mortality rate. The current crises of injection drug use and opioid use disorder have contributed to high rates of infective endocarditis in the United States. Endocarditis in patients who inject drugs involves additional management complexity for multiple reasons. Several infective endocarditis management guidelines exist, including from the American Heart Association and the European Society of Cardiology.