Pharm & Cheese: A Case of Intractable Emesis

May 10, 2026

We start this Wednesday’s Pharm and Cheese off with something unappetizing: emesis. You’re rounding on Red Team and meet a patient with a history of cholangiocarcinoma on chemotherapy who isn’t tolerating PO pending a CT scan. He has normal vitals and a benign exam, but he tells you that for the past two weeks he’s had intractable emesis, even when not eating or drinking. He initially thought it was just from chemo, but his last round was 3 weeks ago and he hasn’t improved.

Samson Frendo MD and Eric Leser MD

The Heart of the Matter: Acute Pericarditis

May 10, 2026

44-year-old otherwise healthy male presents to the emergency department with chest pain. The pain started yesterday mid-day and is described as central and substernal with radiation across the chest and up into the throat. The patient also reports shortness of breath worse with deep breathing and exertion. The patient is incarcerated but otherwise has no historical risk factors for tuberculosis, pulmonary embolism, or cardiac disease. An EKG (Figure 1) is obtained.

Michael Hohl MD and Ari Edelhiet MD

Pharm & Cheese: High Versus Low Dose Thiamine for AUD

April 22, 2026

Bedside Clinical Question: When to use high dose vs low dose thiamine in alcohol use disorder (AUD)?

Alejandra Alvarez PharmD (PGY1) and Joanne Routsolias PharmD

the County Consult