Welcome to #MedTweetorials

1/ #UncleBob has many thoughts about this tragic tale of diagnostic errors!
@UAB_ID @uabimres @acp @sgim @BradSpellberg @PaulSaxMD @AnaerobeSociety
Hard to Swallow | NEJM https://www.nejm.org/doi/full/10.1056/NEJMcps2100980#.YWRHE9_7xdc.twitter

70F presents with SOB. You're asked examine the cardiovascular system.

You look at the legs and detect peripheral oedema. What would you do next?

Open this thread and I'll share my approach.

#MedEd #Tweetorial
#MedTwitter #MedStudentTwitter
@thecurbsiders @CPSolvers @grepmeded

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📢Hot take: Spasticity ≠ Rigidity ≠ Contracture

To understand why, you must understand the common denominator among these terms 🧵

#TeamPhysiatry #Physiatry #PMR #Neurology #MedEd #RehabTwitter

"VEXAS SYNDROME", a multidisciplinary team of researchers @genome_gov have identified this new disorder:
(1/8)
➡️Monogenic adult-onset autoinflammatory disease affecting males ♂️👨‍👦

A review of patellar maltracking and lateral retinacular releases in primary TKA.

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It’s time for another #EndNeurophobia #tweetorial!

PUPILS AND ANISOCORIA

#MedStudentTwitter #neurotwitter #MedEd
@DxRxEdu @rabihmgeha @CPSolvers @Tracey1milligan @NMatch2022
🧠❤️

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Did you know that heparin can cause hyperkalemia?

But why would an anticoagulant like heparin increase serum K⁺ levels?

The answer also has a wild implication - that heparin may itself have a diuretic effect...

#medtwitter #tweetorial

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Hi #dermtwitter! I'm working with @jmervak et al, who put together this amazing #tweetorial on

NAILS!

Specifically, findings in the setting of systemic diseases: let nails help your diagnosis!

Coordinated with @naildisorders

#medstudenttwitter #medtwitter #meded #FOAMed

1/ #medtweetorial on bacteremia real or not real?
A 70yM comes in with SBO and tachycardia and leukocytosis. Blood cultures are sent on admission. 1 out of 2 comes back with Clostridium spp (not perfrigens/ septicum). To treat or not to treat?

1/ We covered a MASH of pearls during the most recent episode with @SAIRABT ! Let's take a look at some of those points with some new (and prior) @febrilepodcast graphics!

For example, what @ID_fellows hasn't gotten called about rabies?! Check out this refresher #IDMedEd

We had an excellent morning report case of Immune checkpoint inhibitor-related hypophysitis in a patient on ipilimumab/nivolumab for metastatic melanoma. Presented by PGY3 Joud El Deek & facilitated by @jkidd03!

A thread🧵

Have you diagnosed an aortic fistula on imaging? @TheAishG, @KapoorRadMD, @MaansiParekh from @JeffersonRads have provided us with an excellent review of imaging of aortic fistula in the current @Radiographics article.

https://bit.ly/2VU4Fdt

#RGphx @cookyscan #tweetorial https://twitter.com/RadioGraphics/status/1442189491180032003

Hey #MedTwitter,

Obesity prevalence varies according to the region and affects up to 40% of the adult population.

Have you ever heard about obesity-induced hypogonadism?

Follow the 🧵

1/ #UncleBob is working to better understand hepcidin. Please critique this so that we can have a better understanding.

Hepcidin is a peptide hormone. Its main function is the regulator of iron entry into the circulation

Time for a #tweetorial!
In my medical training, I have seen several patients without cardiac history who have EKGs with prominent R waves in lead V1. Check out this 🧵for a differential diagnosis framework on categories and causes of large R waves in V1! #meded @CardioNerds

A #tweetorial on our last @TheDermConsult case:

PANCREATIC PANNICULITIS!

#meded #foamed #dermtwitter #MedTwitter
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Why do some prenatal vitamin companies advertise Docosahexaenoic acid (DHA) in their products, what it is and is it safe/recommended for pregnant women?

Do you know what DHA is?

1) Welcome to our accredited tweetorial on Specific #MultipleSclerosis Care Needs for Women of Child-Bearing Age. Expert faculty Alissa Willis @myelinMD. Earn 0.5h CME/CE credit by following this thread. #MStwitter #neurotwitter @MedTweetorials @JennyFengMD @alisecarlsonmd

1/ 🧵

Time for a #tweetorial on simple #ECG interpretation

When I learned to read ECGs, my biggest fear was to miss an important finding!
To avoid that: Be systematic❗️

My simple approach to ECGs with 8 steps 🪜👇

#medicalstudent #education #cardiotwitter #medtwitter #EPeeps

Today, the brilliant @MariaMjaleman messaged me asking about lipoprotein lipase and hormone-sensitive lipase.

My suggestion: think about diabetes emergencies.

DKA: ⬇️ insulin.
HHS: ⬆️ glucose

How to connect these enzymes, DKA, and HHS?
Follow the 🧵inspired by @MariaMjaleman

1) Welcome to a #tweetorial on diagnosis and management of #PulmonaryHypertension. Accredited for 0.50 CE/#CME credits by: #physicians #nurses, #pharmacists! Expert faculty @SudarRajagopal. Follow us serially and also check out our prior #tweetorials at http://www.cardiometabolic-ce.com

⁉️What is the difference between mineral and organic acidosis?
⁉️Why does one cause more hyperkalemia than the other?

Join me on this 🐇🕳️rabbit hole #tweetorial on metabolic acidosis and it's effect on potassium.

📊To start, which type of acidosis causes more hyperkalemia?

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#Tweetorial on IAMI trial

💔💉 Does influenza vaccination improve prognosis in patients who have had an acute myocardial infarction?

@FrobertOle et al. Investigated this in a well executed trial!

https://bit.ly/2YHycZe

@CircAHA @MedTweetorials #medtwitter #cardiotwitter

#idboardreview 25 military M recent return from Iraq: F, myalgia, arthralgia, HA, cough x1wk, mild abd pain, exposure to goat herders & bought a wool rug. +sick contacts w/ flu like sx. wbc3k, plt 110 Cr1.2, mild ⬆️AST/ALT. +interstitial pneumonia. dx? #medEd #idmedEd #idtwitter

1/18 Chest pain is a frequently seen reason for admission. Here's my take on when to consider ACS in patients with chest pain!
#MedTwitter #CardioTwitter #MedEd #FOAMed #MedTweetorial @MedTweetorials

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Why does Wenckebach AV nodal block (aka Mobitz type 1) present with progressive prolongation of the PR interval and eventually a non-conducted P wave? 

What causes this unique EKG pattern to arise?

#medtwitter #tweetorial

1/ As a follow-up to my recent @UNMC_ID blog post on the new @CDCgov STI guidelines, it's time for a #tweetorial to review changes for Gonorrhea, Chlamydia & Mycoplasma genitalium management. See the full post for the details! #IDTwitter @ID_fellows

https://twitter.com/JonathanRyderMD/status/1433095628335222790

Weekend Digest
Name the pathogen!

5 Clues:
Rodents.
Triathlon.
Conjunctival suffusion.
Jaundice.
Jarisch-Herxheimer.

The last few weeks have been tough. For those in need of a light hearted thread, here’s a brand new 3rd #tweetorial in my extremes of #physiology series. What can the animal kingdom teach us about our physiology?

Buckle up for some fun animal pulmonary facts 🫁!
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Let's talk about procalcitonin -- can it definitively tell you if there's a bacterial infection? Well-- nothing in medicine is that simple.

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This week, I gave a talk about one of my favorite clinical topics: #preop medication management! One class of meds I covered was anticoagulants. Let’s quickly review how to handle preop DOAC interruption in this 🧵:
#MedTwitter #MedEd #FOAMed

A short fact of the day about Drug reaction w/ eosinophilia & systemic symptoms #DRESSsyndrome

It is a severe drug reaction characterized by a widespread skin rash with variable organ involvement, lymphadenopathy, eosinophilia, and atypical lymphocytosis.

1/Currently on my cystic fibrosis rotation with @NaumanChaudary1. See below for a brief 🧵from today's learning points on CF diagnosis. This flow diagram from @JPediatr demonstrates the appropriate diagnostic algorithm. #tweetorial @VCU_PCCM @lkbrath @PSinkam @crit_caring_MD

#ClinicalMinute
So you have a patient with hyponatremia, they look euvolemic on exam. Now what do you do?

Red Tide Implications on Pulmonary Functions: How does Red Tide cause Respiratory Distress?

I went to the beach a few months ago. It was filled with dead fish on shore and brown water, the infamous Red Tide.

To make it even worse: I. Could. Not. Breathe.

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If you're expecting to see this👇every time you think dissection, you'll be missing a lot of dissections (>40%). Everyone talks re widened mediastinum but its absence does NOT exclude it. Let’s chat about pitfalls of dissection.
#MedTwitter #FOAMed @MedTweetorials @RosenelliEM

Almost exactly a year ago, I had a modestly controversial tweet about routine daily physical exams -- and about how we should probably spend more time actually talking to our patients daily rather than pretending to examine then.

https://twitter.com/adamrodmanmd/status/1295417747984261124

1/ #Tweetorial Part 2- Now its time to talk about….

CHRONIC

C-L-O-T

#VTE #DVT #Thrombectomy #Lytics #Cardiotwitter #IRAD #Medthread #Clot @CardioBot @RadialFirstBot @BotPci @EPeeps_Bot @TAVRBot @MedTweetorials @UjjwalRastogiMD @Umair2017 @Umair2017 @VenuVadlamudiMD

Hey, #medtwitter

Have you ever heard of Simpson's Paradox?

Our field is full of observational studies and many people are now looking at observational data from COVID-19 vaccines.

Don't be fooled by data.

Follow the 🧵

#MedEd

I had a great time presenting an awesome future @hdx case that some of my students @1LECOM created to @CPSolvers on Friday VMR to @DxRxEdu & @rabihmgeha (who solved after the 2nd aliquot, genius).

Check out the case or follow along for some pearls https://clinicalproblemsolving.com/morning-report-august-20-2021/