Welcome to #MedTweetorials

1/6
Can insulin drips be used for more than DKA?

45yo man w/ T2DM on insulin, HTN, h/o hypertriglyceridemia induced pancreatitis presents w/ constant severe epigastric pain x 1 day. TG levels >1500.

Why was an insulin drip started? #medtwitter #tweetorial

I don't often post @MedTweetorials but when I do, it is cause I am bias! This is a great guideline! The new VA lipid guidelines. Let's take a brief look at major recommendations and some reasons behind them.
#FOAMed #medicine #cholesterol
@AnnalsofIM

https://www.acpjournals.org/doi/10.7326/M20-4648

1/5
Why is meperidine (Demerol) particularly good at treating rigors?

This is another association I learned early in training without hearing a potential mechanism.

For the second installment in my fevers, chills, and rigors tweetorial follow-up, let's have a brief look.

#idboardreview 🐁 in 🏡
15 F Initially presented outpatient w/ F, photophobia x5d➡️improved w/ supportive care➡️1 wk later:HA & stiff neck, F 102F, csf ⬆️wbc 68% lymph, culture negative. Diagnosis? #medEd #IDMedEd

Are you captivated by the new @Netflix series #AwayNetflix (caution: spoilers!) but have no idea what’s going on with the subplot about the #stroke? This #Tweetorial may be for you.

First tweetorial of the new academic year. Coagulase negative Staphylococci (CoNS) bacteremia is a frequent ID consult. So how do the pros handle the CoNS? Here is a quick generalized approach I use by creating a mnemonic out of CoNS. 1/10

Check out this great review on BRUE's or “brief resolved unexplained event” @EMBoardBombs by @blakebriggsMD and @Lmellick here, https://www.emboardbombs.com/papers/2020/9/16/scary-seconds-brief-resolved-unexplained-event-brue

Or follow along for a short #medtweetorial review on the highlights. #EM #EMPeds #EmergencyMedicine #MedTwitter https://twitter.com/EMBoardBombs/status/1306548537950339072

ID Miscellany|physical Exam|Signs|Humanities #idmesh
1/20
𝙁𝙀𝙑𝙀𝙍 𝙋𝘼𝙏𝙏𝙀𝙍𝙉𝙎: 𝘼 𝙇𝙊𝙎𝙏 𝘼𝙍𝙏?

Great! Three quarters find inquiring about fever patterns still useful. We will review some of the most important fever patterns.

@ID_fellows

https://twitter.com/WuidQ/status/1305649807395033088?s=20

1/14
Why do we feel cold (i.e., experience "chills") when we have a fever? Shouldn't we feel hot?

And what are rigors?

Answers to these questions will help us better understand when we should obtain blood cultures.

When do you think is the best time to draw them?

1/The Liver Blood Tests: A case exploration from Tuesday's Zoom (https://bit.ly/2ZyBjAc more in video!)

CC: 43 yo M with 3m of fatigue + pruritus
LCT: TPro 4.9/Alb 1.6 /TBil 27.8 /DBil 23.9 / AST 147 / ALT 152 / AlkPhos 1249
#MedEd #MedStudentTwitter
What is your impression?

1/ #medtwitter #tweetorial Raise your hand if you have ever inappropriately checked an ammonia level.🙋
1. Why is ammonia ⬆️ in liver failure and how is this connected w/ encephalopathy?
2. When should levels be checked?
3. Aside from cirrhosis, what other conditions ⬆️ammonia?

On consults this weekend, I faced a question of whether a patient's thrombocytosis was secondary to iron deficiency or due to a clonal process, and it got me thinking...

Why does iron deficiency (ID) cause thrombocytosis?

Dear MRI readers:
T2 hyperintensity in muscle ❌DOES NOT mean❌ #myositis. All it means is edema of any sort.

Follow this thread for examples and feel free to share yours
#MedTwitter #Neurotwitter #MedEd #radiology @RadiologySigns #Muscle @MedTweetorials @mayoneurores

#MayoIDQ Case by Dr. @N_CastilloMD

68F. Aortic stenosis, COPD, RA.
CC: chest pain / dyspnea
CXR: CHF. TEE: AV mass / perivalvular abscess
Routine blood cultures (-)

You order serologies of culture-negative endocarditis. Which of the following is most compatible with Q fever?

I am quarantined in London, so #Tweetorial time💂‍♂️⏰

Should we treat subclinical hypothyroidism during pregnancy?

A tweetorial on physiology, overdiagnosis, risk stratification and treatment harms.

Do you treat subclinical hypothyroidism during pregnancy?❌✅

Hi #MedTwitter #MedStudentTwitter! This is for the #MS4's🩺Residency Interviews🎙️- Showing Your Best Zoom Self: Part2⃣ Tag an MS4 that you know, and comment with your pearls!😄

Hi #MedTwitter and #MedStudentTwitter! As #MS4's gear up for virtual interview season, I thought I create this #Tweetorial: Residency Interviews - Showing Your Best Zoom Self🕴️‍♀️🕴️‍♂️💻 (let me know your thoughts and suggestions!😄)

1/
#Melanoma can look like anything: a #Tweetorial

Most melanomas are fairly easy to recognize but the outliers are pretty crazy.

Like this example with signet ring cells 👇🏾👇🏾 https://twitter.com/DermwizGuy/status/1217188181914849280

Contaminated blood cultures have been recognized as a troublesome issue for decades. This comes at a big cost, with additional costs associated with this unnecessary treatment were approximately $1,000 per patient.

1/7
Can EtCO2 replace ABGs in the ICU? Here's an intern's perspective. While rounding in the MICU, I noticed that sometimes we changed ventilator settings based on EtCO2 values while at other times we used ABGs. Here’s my 1st attempt at a #Medtweetorial to understand why.

Welcome to a Tweetorial. This week I learned there’s a such thing as chronic meningitis, so I decided to make a 🧵:

Main Source: Harrison's Infectious Disease, Ch. 37