Welcome to #MedTweetorials

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

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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

24F presents with 3-months of fatigue, arthralgia and a facial rash. What would you be thinking?

Open this thread and I'll explain my approach and reveal the final diagnosis.

@MedTweetorials #MedTwitter
@AndreMansoor @thecurbsiders @grepmeded

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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

40F presents with a swelling in her neck. What would you be thinking?

Open this thread and I'll explain my thought process and reveal the final diagnosis.

@MedTweetorials #MedTwitter
@AndreMansoor @CPSolvers @grepmeded

#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

20F presents with 1-week of sore throat, fever and malaise. You examine their throat and here's what you find.

What would you be thinking? Open this thread and I'll explain my thought process and reveal the final diagnosis.

@MedTweetorials #MedTwitter
@AndreMansoor @grepmed

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/

Hi #medtwitter #neurotwitter #medstudenttwitter #meded #FOAMed

It's been too long since my last #EndNeurophobia #tweetorial. As requested by @sukritibanthiya here is a tweetorial on MUSCLE DISEASE (MYOPATHY)

Let me know what you think and what I should cover next!

1/ Good day, #MedTwitter, and welcome to the latest installment of #ReadingRoom. Dim the lights, and prepare to correlate clinically!

Take a look at the x-ray below: what is the labeled object? (hint: where is it?)

1/ “Visual representations are time-efficient and designed to engage the reader's visual processing capacity and decrease #cognitive workload.”

How do you start w/ #infographics & visual abstracts?!

🧵 on Rip Out w/ @AylC1989 @AndrewMIbrahim & Amy Ou ! https://doi.org/10.4300/JGME-D-21-00590

We need to talk about the pediatric bed situation in the USA.

Because things are going to get really bad, real fast, unless people doing things to stop it.

This is an important thread. Please share.

#delta #deltavariant #pediatric #covid #schoolreopening

🧵 1/n

1/16
Why do we use a vaccine (BCG) to treat an unrelated malignancy (bladder cancer)?

Can infections really prevent/treat cancer?

Let's find out.

Last session of my @PHMConf x @TheCribsiders conference! CBC Demystified! #PHM21 #PHM21Game Will be live-tweeting some high yield slides for #CribsidersAtPHM here follow below ⬇️⬇️⬇️ #MedEd

Today on @CPSolvers #VMR, there was a great case of #Jaundice that was presented by @AraujoLauraMed to @DxRxEdu @rabihmgeha

You can listen here for the case or follow the teaching points on the final dx...

https://clinicalproblemsolving.com/morning-report-august-13-2021/

90M referred by community carers. They're concerned he lacks capacity because he won't let them in to clean her house.

How would you assess capacity? Open this thread and I'll share one approach.

@MedTweetorials #MedTwitter
@GeriPalBlog @AlexSmithMD @EWidera

I was taught, and continue to hear it taught, that the history of present illness (HPI) should be crafted to "convince the listener/reader of your suspected diagnosis."

I think this framing is problematic...

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1/🧵Fluids in sepsis: When a patient’s blood pressure is too low and they are in shock, as happens all the time with #COVID19 viral #sepsis, we give fluids. This @bmj_latest figure👇makes a bit of sense of where the fluid goes. Let me unpack a bit more…

https://bit.ly/3lvrL50 https://twitter.com/Paul_Wischmeyer/status/1420750248771686403

ECTHYMA GANGRENOSUM!

A #dermtwitter/#medtwitter #tweetorial!

Remember this photo from the last episode of @thedermconsult? Congrats to those of you who correctly identified the diagnosis. But let's delve deeper into the diagnosis.

#meded #FOAMEd #medstudenttwitter
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#IDBoardPearls #IDtwitter #IDPhotoQuiz

📟 8 YO admitted w/ flushing, an urticaria rash on face & torso, and itching
His mom says the rash occurred within an hr of him eating a tuna sandwich. He complained of a spicy taste & had perioral burning causing her to seek medical help

Why we #pocus , a thread:

35 year old male with severely uncontrolled diabetes presents to the hospital with fevers and cough. Chest x-ray shown here: