Welcome to #MedTweetorials

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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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ESR-CRP discordance,a #MedTwitter #tweetorial

First off, let’s talk about ESR physiology.
ESR is the rate at which RBCs settle in plasma of an anti coagulated blood sample.
(-) charged RBCs repel each other thus ⬇️ ESR.

(1/12)

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You suspect pneumonia, but the CXR shows no opacities.

Q: When should you obtain a chest CT?

Pick your answer, then read on for a short explanation

(PTP = pretest probability)

You see a patient on the ward with an exacerbation of heart failure.

The team has inserted a urinary catheter for fluid monitoring. What would you do?

Open this thread and I'll share my approach.

#MedEd #Tweetorials
@MedTweetorials @SocietyHospMed
@tony_breu @AndreMansoor

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🤔 Why do patients with acute myocardial infarction often present with diaphoresis (sweating)?

And, is there any significance when this symptom is present?

🎟️Let's have a look.

1) Welcome to a new #accredited #tweetorial, Prevention and Management of Heart Failure in T2 Diabetes: The Diabetologist’s Perspective! Our expert author is Melanie J Davies CBE FMedSci @profmjdavies, Prof of Diabetes Medicine, U Leicester, Leicester Diabetes Unit @LDC_Tweets

A patient presents with shortness of breath. You're asked to examine their respiratory system.

Looking at their hands you notice something different about their fingernails.

What would you thinking?

#MedEd #Tweetorials
@MedTweetorials
@AndreMansoor @PeteSullivanPDx

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My fellows complained they hate memorizing classifications, like LeFort. I thought, “There must be a better way—maybe understanding instead of memorizing.”

A #tweetorial about understanding the LeFort classification. #FOAMed #medtwitter #Medstudenttwitter @medtweetorials

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Awhile ago, on a triage call: “I’ve got a guy here, pretty young, came in looking terrible. GCS 4, we intubated him. Scan shows a big bleed. ICH score 4. Not sure much you’ll be able to do, but need to transfer him.”

A #tweetorial about the ICH score. @medtweetorials

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What is a “clinical pearl” exactly? Diagnostic criteria and framework, a thread 🧵:

1/During case conference (& on rounds), we often see master clinicians come up w/ brilliant diagnoses before the HPI is even finished.

But how did they get there?
And how can you teach yourself & others those skills?

This week: how to teach diagnostic reasoning more explicitly

#Medtwitter, last week I posted about a talk I gave on teaching #clinicalreasoning

As promised, the accompanying #tweetorial

Come explore with me!
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https://twitter.com/AnandJag1/status/1519499322236178433?s=20&t=XFdniGzBgA8tQ3tB4LcW6g

Should you give albumin with loop diuretics to augment diuresis?

I've been asked this three different times today so a quick🧵of my thoughts

#nephtwitter #MedTwitter @MedTweetorials

#NeudrawlogyMigraineEdition, part 6! 🤕🧠

Did you know that migraine has different presentations in children 🍭 compared to adults? 🧵 (1/12)

#NeuroTwitterNetwork #NeuroTwitter #FOAMed #MedEd #MedTweetorial

1/ Happy Tweetorial Tuesday from @ChrisDJacksonMD!

Clinical pearls? Evidence based medicine? Are we trying to mix oil and water?

Don't worry, your #MedEdTwagTeam crew is here to help with this week's thread!

1/ Hello #Medtwitter #NephTwitter.
Different urine colors and the pathology it signifies is amazing!
Milky white urine is one such color we dread. What does it signify? Lets read on🧵
#ASPNFOAMgroup @ASPNeph #ASPNeph #pedneph #chyluria

Hang around #MedTwitter for a while, and you’ll find someone claiming that there aren’t enough residency positions for U.S. medical students, or that residency positions aren’t growing at the same rate as medical school graduates.

Trouble is, neither is true.

(a 🧵)

🤔 Does metformin cause vitB12 deficiency?

❗️Metformin is the most prescribed drug for type 2 diabetes. Should you monitor vit B12 in pts taking it?

Follow the🧵

#MedTwitter #tweetorial #Endotip

60M has an incidental finding of a raised haemaglobin. How would you investigate?

Open this thread and I'll share my approach.

@MedTweetorials
#MedTwitter #MedStudentTwitter
#MedEd #Tweetorial

@CPSolvers @Grepmeded
@ManualOMedicine @AnandJag1

ILD clues for the internist: here's a 🧵with some quick hits!

Framework by @DrEricStrong:

https://www.youtube.com/watch?v=EqGT7IgUHU8

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