University of North Carolina Internal Medicine Team Descriptions

and Patient Populations Served

Updated 4/12/2006

Note: Please review previous discharge summary and/or clinic note for guidance about which service most recently took care of the patient.

Medicine A (Geriatrics, generally age 60 or older)

1. Failure to thrive

2. Altered mental status of unclear etiology

3. Syncope/recurrent presyncope

4. Urosepsis

5. Dehydration and/or electrolyte abnormalities

6. ARF in elderly

7. Pneumonia in elderly

8. Orthopedic fractures in patients who are poor surgical candidates

Medicine B (Nephrology) * If nephrology is not on call, please consider sending patients meeting these criteria to Gen Med (Med U), or the hospitalist service (Med H) in that order.

1. ESRD (the division of nephrology would like to care for all their patients unless there is a service need that might be better fulfilled by another service—eg pulmonary fibrosis would go to pulmonary)

2. Kidney Transplant ( > 30 d post-transplant)

3. Primary diagnosis of acute or chronic kidney disease

4. Complicated hypertension (not requiring ICU/CCU level of care)

5. Vasculitis

6. Primary diagnosis of Lupus or Scleroderma

7. Hyponatrmia/hypernatremia

Medicine C/D (Cardiology)

1. Acute ST-elevation MI- **Continue to contact cardiology fellow on call first**

2. Non-ST elevation MI or unstable angina

3. Congestive Heart Failure

4. Hypertensive urgency/emergency

5. Flash pulmonary edema

6. Complications in heart transplant patients

7. Arrhythmias

8. Cardiomyopathies

9. Complications of recent cardiac catheterization (hematoma)

10. Valvular heart disease

Medicine E (Hematology/Oncology)

1. Acute Hematologic Malignancy (AML, ALL, high grade lymphoma and acute problems arising from malignancies or suspected malignancies—see problems 2-6 )

2. Scheduled chemotherapy

3. Neutropenic fever

4. Cancer pain

5. Oncologic emergency (Cord compression, tumor lysis syndrome (TLS), SVC syndrome, hypercalcemia)

6. Failure to thrive, altered mental status or acute renal failure likely related to underlying malignancy

7. Sickle Cell Anemia

A. Pain crisis

B. Hypoxia/chest pain/fever – suspect acute chest syndrome

8. Hemophilia

9.. Thrombocytopenia including TTP/ITP , but not secondary to liver disease

10. Aplastic anemia and other bone marrow disorders requiring inpatient care

Medicine G (Pulmonary)

1. Cystic fibrosis exacerbation

2. Post lung transplant complications

3. COPD exacerbation

4. Pneumonia – severe or with co-morbidities

5. Venous thromboembolism (VTE) – DVT or PE

6. Hypoxia or severe dyspnea with no clear etiology

7. Bronchiectasis

8. PCP pneumonia

9. TB evaluation

10. Sarcoidosis and interstitial lung disease

11. Hemoptysis

12. Asthma

13. Pleural effusions ( not secondary to heart failure or cirrhosis).

Medicine K (Infectious Disease)

1. HIV with opportunistic infection or suspected opportunistic infection

2. End stage HIV with FTT

3. Diabetic Foot Ulcer

4. Osteomyelitis

5. Bacteremia

6. Urosepsis (consider Med A if elderly)

7. Fever with unclear source

8. Severe cellulitis, concern for deeper tissue, fascial, or muscle involvement

Medicine U/W (General Medicine)

1. Med U will admit Nephrology patients if Med B isn’t on call

2. Low risk chest pain, cocaine positive chest pain

3. Cellulitis

4. Pancreatitis

5. Alcohol withdrawal syndrome, only with medical comorbidities

6. Liver disease (cirrhosis) with complications

A. Hepatic encephalopathy

B. ARF

C. Spontaneous Bacterial Peritonitis (SBP), or belly pain suspicious for SBP

7. Upper GI Bleed (UGIB)

8. Lower GI Bleed (LGIB)

9. Hyperglycemia except DKA

10. Drug overdose

11. Hypertension, severe, or with end organ damage, or acutely elevated above documented historic levels

12. Vomiting with inability to maintain hydration

13. Inpatient liver transplantation evaluation

14. Inpatient management of inflammatory bowel disease

15. Inpatient management of biliary disease

Medicine H (Hospitalists, Gen Med) *Please intersperse patients to the Med H service when Med U/W is receiving several admissions during the day.

1. Generally the same patient population as Med U, W ( gen med), and geriatrics (Med A).

2. Nephrology patients on days when Med B isn’t on call or when Med B or Med U is capped

3. Chest pain service patients, i.e. very low risk chest pain.

4. Dermatology patients requiring inpatient admission ( severe drug reaction, etc.)