Welcome to #MedTweetorials

A 3-year-old boy 👉 with fever, vomiting, and these skin lesions👇

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Why is a ketogenic diet a potentially effective treatment for refractory epilepsy?

There's something almost magical about the idea that a specific type of diet could reduce the risk of epileptic seizures.

Let's explore why that might be.

#medtwitter #tweetorial

🧵regarding the chromic suture: a 'classic' older suture material that still remains in use today.

We'll go over some properties, a little history, and some of what each of the sizes are (and were) used for.

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🧵of 🧵's.
We've done chromic...now for one of the most versatile of all sutures...polydioxanone or PDS.

As usual, we'll go over some properties, a little history, and some of what each of the sizes are used for.

🧵of 🧵...we've done chromic and PDS (links at the end).
Now we'll cover the Nickelback of suture material...silk.
I use the analogy because silk has been around a long time: it's irritating, no one admits to using it, but they do; and you think it'll never go away, but it does.

1/Time is brain! So you don’t have time to struggle w/that "stroke alert" head CT
Here’s a #tweetorial to help you with the CT findings in acute stroke #medtwitter #FOAMed #FOAMrad #medstudenttwitter #medstudent #neurorad #radres @medtweetorials #stroke #neurology #Neurosurgery

💡💡 New Publication Alert‼️ 💡💡

Of interest to all those who love Diagnostic Reasoning!!!

(And chief residents and others who run Medicine Morning Reports or teach courses in clinical reasoning!!)

https://pubmed.ncbi.nlm.nih.gov/35942949/

270,000 Americans die of sepsis each year.

But we can't agree on how to diagnose it.

The problem is more complex than you think...

A thread 🧵

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🤔Why does subarachnoid hemorrhage lead to deep/inverted "cerebral T-waves"?

This ECG finding is so dramatic. But as we will see, these patients often have normal hearts.

Why does an issue in the brain manifest on a test of the heart?

Hey #MedTwitter, these are 100 of my #MedEd tweets compiled for some quick #hematology revision. I hope you find it useful 👍

@MedTweetorials @EHA_Hematology @NicoGagelmann @pankti4299 @AbbasiMuqtadir

⚡️ “Hematology Tweets & Threads !!” by @nihardesai7 https://twitter.com/i/events/1391373171140354052

How does Cushing cause hypokalemia?

- One of the many questions that came up during today's @CPSolvers VMR weekly recap.😁

@rabihmgeha @MadellenaC @Rafameed @rav7ks @deboracloureiro 💙

For the answer, follow this thread 🙂

ICU stories: Walking to the ICU early am & before getting sign-out from the nocturnist covering the ICU, I'm greeted by the nurse of the pt in room 428
– Can u take a look at this pt? I keep going up on levo, now @ 0.15. Middle-age pt w hx of ESRD on HD/afib/CHF/cirrhosis etc etc

Middle aged person comes in with headache. CT (from https://www.cureus.com/articles/68994-nonepileptic-stereotypical-and-intermittent-symptoms-after-subdural-hematoma-evacuation and for illustrative purpose only) with acute #SDH. GCS 15 and non focal exam. Patient on Xarelto. A 🧵on SDH:
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Here is the thread containg all master classes by @Lpa_Doc

When applying to residency, most people dread writing personal statements.

Having written and given feedback on many personal essays over the years, here are 5 tips that I think can make it a little easier. // 🧵

1/ Do you take care of pts with aneurysmal SAH (aSAH)? How many of them experience vasospasm (VSP) / delayed cerebral ischemia (DCI)? A thread on pathophysiology and novel strategies

ICU stories: Eldelry pt w CAD s/p multi-vessel PCI / DM2 / HTN presented to the ED w epigastric "burning". Symptoms much worse with laying down & while eating. No relief w iv famotidine; got relief with morphine. Troponin I elevated and peaked at 1,000 (nl <15). ECG:

Hypercalcemia: A Tweetorial for Internist

Calcium regulated to levels between 9-10.5 mg/dL

↑PTH = ↑calcium
↑Calcitonin = ↓calcium

PTH produced by the chief cells in parathyroid glands
Calcitonin produced by the parafollicular cells in thyroid

1/ “Now listen carefully!” Does the word “tbone” make you think of a tough guy nickname before ear anatomy? Do you know the CT ice cream cone & then nada? Then you need this #tweetorial on tbone anatomy! #medtwitter #FOAMed #FOAMrad #medstudent #neurorad #radres @medtweetorials

Finishing the series on scalpel blades (we’ll get to other stuff, I promise).

In this 🧵 we’ll explore the difference between plastic disposable scalpels and ‘real’ steel surgical scalpels.

Or is there a difference?

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🤔Why does iron deficiency cause fatigue, even in the absence of anemia?

I have often equated iron with hemoglobin and oxygen-carrying capacity.

But there is so much more to it!

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Ever wonder why tick bites can lead to a red meat allergy, including even anaphylaxis?

The answer requires us to examine sugars, tick saliva, and an anti-cancer drug.

#medtwitter #tweetorial

Today's 🧵continues our exploration of scalpel blades with an opinion about a simple and common surgical maneuver.

Very often, you have a small skin incision and you need to make it a little bit longer. Yet even that simple move often goes wrong.

A patient comes in for these skin findings. He says he’s getting darker everywhere. He’s frustrated because he moved to the countryside a few years ago to “get away from the stress of the city,” & now keeps getting headaches!

Diagnosis?

#dermtwitter #medtwitter #meded #FOAMed

1/Do radiologists sound like they are speaking a different language when they talk about MRI? T1 shortening what?T2 prolongation who?
Here’s a translation w/a #tweetorial introduction to MRI
#medtwitter #FOAMed #FOAMrad #medstudent #neurorad #radres @medtweetorials #neurosurgery

You’re an intern called to review a patient with an isolated BP of 170/100.

They're admitted with community-acquired pneumonia.

Would you prescribe an antihypertensive? Open this thread and I’ll share my approach.

#HighValueCare #ChoosingWisely
#MedTwitter #MedStudentTwitter

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🤔Why does multiple myeloma cause anemia and not pancytopenia?

If the issue is infiltration of the bone marrow with plasma cells, wouldn't all cell lines be low?

Let's have a look.

1/Understanding cervical radiculopathy is a pain in the neck! But knowing the distributions can help your search
A 🧵to help you remember cervical radicular pain distributions #medstudenttwitter #medtwitter #radres #FOAMed #FOAMrad #neurorad #Meded #backpain #spine #Neurosurgery

1/Radiologist not answering the phone?Just want a quick read on that stat head CT?

Here's a little help on how to do it yourself w/a #tweetorial on how to read a head CT!
#medtwitter #FOAMed #FOAMrad #medstudenttwitter #medstudent #neurorad #radres @medtweetorials #neurosurgery

There are ~350,000 sudden cardiac deaths (SCD) each year in the US (almost 1000 per day).

Most SCD occurs in older people with known coronary disease, but, sadly a minority of sudden deaths occur in the young.

Roughly 1500 people under 25 die of SCD each year in the US.

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One of my favorite #histmed stories is the discovery of EEG by Hans Berger in the 1920s. #NeuroTwitter

At age 19, Berger (1873-1940) fell off a horse. On the same day, his sister, miles away, sent a telegraph to ask if he was doing ok. 1/10

Short 🧵regarding the Poole suction tip: what it's for, why you may not fully understand how it works, and (of course) a little of its history...

76M with end-stage COPD presents with breathlessness and severe hypoxia. There is no reversible cause on workup.

Would you use high flow nasal oxygen for symptomatic relief?

Open this thread and I’ll share my approach.

#MedEd @MedTweetorials
#MedTwitter #MedStudentTwitter

💥 Approach to Elevated Tryptase 💥

A patient without a history suspicious for anaphylaxis or angioedema presents with an elevated serum tryptase.

How do we interpret this uncommonly sent lab test?

Short 🧵regarding what it means when a needle driver has a gold handle.

The gold handles are not just cosmetic: the needle drivers actually *are* better.

To understand this, we have to know what is meant by the 'jaws' of the needle driver.

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Tweetorial. 1/🧵. Scapular winging.
A young man with shoulder pain after a road traffic accident. His back looks like this

1/Mike Tyson once said, “Everyone has a plan until they get punched.”
In honor of all the great hooks and crosses—here is a #tweetorial about mandibular fxs! #FOAMed #medtwitter #Meded #neurorad #HNrad #FOAMrad #Medstudenttwitter @medtweetorials

Was helping junior med students with CXR interpretation in their preparation for osces & decided to create a 🧵

Follow along for steps in interpreting CXRs 👇

#MedTwitter
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Ever wondered how MR Spectroscopy (MRS) is acquired & how to interpret it? Have you ever come across funky looking zigzag graph with MRI & scratched your head?

If interested in learning BASICS of MRS, follow this 🧵

MRS for non-radiologists
#EmoryNCCTweetorials @MedTweetorials

Framing lymphomas for clinical reasoning: a Herculean task given long list of diseases in our world of molecular biology.

Here's my first attempt at a summary:

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‘VT’ versus ‘SVT with aberrancy’.

The long list of VT "suggestive" ECG features is difficult to recall and apply in real time.

How can we simplify things?

Here is my ABCDE approach – five simple Qs to ask:
🧵👇

Let's take a ride on the #orthotwitter train and talk about the ACHILLES TENDON!

A 🧵*....

*This thread includes slides that I created with appropriate references when needed.

@AOFAS @AJSM_SportsMed @AAOS1 @NorthwellHealth @ZuckerSoM #medtwitter #MedEd

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The only good thing to come of finding this on my leg last week: I learned enough to write a #tweetorial about it

A 🧵/twitter PSA about what to do if a tick comes for you – & what neuro presentations you can see w/ tick-borne illnesses

#MedTwitter #NeuroTwitter #IDTwitter

A brief thread on the #dermatologic exam for #monkeypox!

Caveat: I myself have not seen a MPX patient, but am piecing information together for my #dermtwitter and #medtwitter colleagues!

#MedEd #FOAMEd #tweetorial

PC:https://www.npr.org/sections/goatsandsoda/2022/05/18/927043767/rare-monkeypox-outbreak-in-u-k-and-europe-what-is-it-and-should-we-worry
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