Discover and read the best of Twitter Threads about #ClinicalPearl

Most recents (23)

A 29-year-old male presented with a 6-month history of progressive painless skin lesions over his face, back, trunk, and limbs. He had no systemic symptoms such as night sweats or weight loss.
Skin biopsy showed diffuse dermal infiltrate with blast-like cells extending to the hypodermis. Immunohistochemical analysis showed cells that were positive for CD4, CD56, and CD123.
Read 4 tweets
Bone marrow examination suggested malignant bone marrow invasion. PET-CT scan showed extensive bone marrow invasion and malignant lymphadenopathy in the anterior mediastinum.
The correct diagnosis is Breast cancer.
Read 4 tweets
64yo woman treated for recurrent triple-negative breast cancer with chemotherapy and radiotherapy in 2014, with no evidence of recurrent disease for the past 7 years, presents with well demarcated erythematous skin changes and a focal necrotic wound.
Symptoms include skin pain, and her symptoms began with a documented COVID-19 infection.
Read 5 tweets
Diagram of embryonic development and characteristics of membrane anatomy under laparoscopy Image
It will probably redefine the surgical scope of complete resections of pelvic tumors (cervical, rectal, and bladder cancer), improve nerve-sparing and pelvic floor reconstruction, and reduce operative bleeding and surgical injuries.
Read 6 tweets
19yo woman who was 34 weeks pregnant presented to the emergency department with a 3-day history of abdominal pain. Physical examination revealed hyperpigmented macules on her lips and CT scan showed intussusception.
The diagnosis was Peutz–Jeghers syndrome
Read 5 tweets
Saline is a powerful surgical instrument. #neurosurgery #bleed #meded #clinicalpearl
Credit to this neurosurgeon Image
Craniotomy for Evacuation of acute subdural hematoma causing compression on brain. See primer on SDH from Netter. Image
Read 3 tweets
Acute pulmonary embolism (PE) is one of the most serious form of venous thromboembolism. The clinical presentation of PE is variable and often nonspecific making the diagnosis challenging.


#CardioTwitter Image

✅ Sinus tachycardia (most common).
✅ S1Q3T3 pattern (may be present up to 30% of cases). 
✅ Simultaneous T wave inversions in the inferior leads and right precordial leads can be seen.
✅ Right axis deviation.
✅ RBBB (complete or incomplete).


#MedTwitter #ecg
CT form a real case with PE.


#medicine #MedTwitter #MedStudentTwitter #ct #pe #ekgdx #ekg #ecg Image
Read 4 tweets
Salter-Harris Classification:

Just remember SALTR (no E) for the Salter-Harris classification of growth plate fractures.

#TipsForNewDocs #MedEd #MedTwitter #medicine #medical #medicare #health #FOAMed #ClinicalPearl #clinicaltips #MedStudents

Read 5 tweets
50 yo female with progressive eye redness and loss of visual acuity. She has a h/o hypertension. Thoughts? #MedEd
#MedTwitter #health #healthcare #FOAMed #ClinicalPearl #clinicaltips #neuroscience #neurotwitter
#sciencetwitter #brain #medstudenttwitter #medical Image
Neuro intact other than vision.
What is reason for redness, specifically?
Read 4 tweets
I learned an interesting #clinicalpearl today!

Did you know that in Wilson Disease, despite high ALT/AST/bilirubin, Alkaline Phosphatase (AP) stays normal or low?

It made me ask "why," & so, I present the answers I found in #tweetorial form.

A rare non-derm, #medtwitter 🧵
Let's start by establishing that Wilson Disease is a multisystem process wherein copper deposits in various tissues (liver, brain, eyes) because of improper transport.

A mutation in ATP7B causes this, and the depositional process leads to disease manifestations.
Given the organs Cu2+ deposits in, you see neurologic effects, Kayser Fleischer rings in the eyes, and of course, liver disease.

While here👇, we see the always memorized, rarely seen, Kayser Fleischer rings, let's focus on the liver...

Read 11 tweets
#Medtwitter #ClinicalPearl

This thread will tell you how Quackery works...
Step 1: Quacks understand the market needs. If patients find oncology treatment painful and expensive, they will 'create' a product for cancer. Quacks understand entrepreneurship
Step 2: Once the "area of need" is identified, quack delivers a product that is relatively cost-effective (and largely ineffective). It could be a mixture of "herbs", "natural product", some fancy-sounding "diet"
Read 19 tweets
#Medtwitter #EndoTwitter #ClinicalPearl

Karyotype must be offered to all women presenting with Premature ovarian insufficiency (POI)
There is no age cut-off per se for ordering a karyotype in women with POI. In a study, more than 30% of women with abnormal karyotype were more than 30 years of age!
Additionally, when you order a karyotype in women, it is also imperative to order FISH to look for Cryptic Y chromosome material
Read 5 tweets
#MedTwitter #ClinicalPearl #Endotwitter

Is your patient having persistently high TSH , despite increasing the dose of your thyroid medications ? The patient on the other hand is asymptomatic and the T4/Free T4 values are always normal. Contd..
High TSH despite adequate LT4 replacement is a common clinical issue that we deal with in Endocrinology and it is an area of several #ClinicalPearl threads
However today we focus on one such issue on possible reason for the problem. The reason is what is called a Heterophile antibody
Read 11 tweets
#ClinicalPearl #MedTwitter

A patient comes to you with a thyroid function test suggestive of Thyrotoxicosis, but the patient has absolutely no clinical features of the same. What do you do ?
In such a scenario, you need to look for Biotin interference with endocrine lab assay

50% of endocrine tests have been developed using biotin in their separation step
A high dose of biotin (defined as biotin intake >5 mg /day) is often a component of dermatological treatment. It is also a treatment for multiple sclerosis.
Read 7 tweets
#ClinicalPearl #MedTwitter

GLP-1 and GIP are both incretin hormones. Incretins are the X factor in the pathogenesis of type 2 diabetes and are a key component of the 'Ominous octet' - the 8 factors that cause type 2 diabetes. Contd..
But GLP-1 and GIP have subtle differences
GLP-1 inhibits insulin and also inhibits glucagon secretion
Read 8 tweets
Symptoms of primary & central adrenal insufficiency are similar. Anorexia, fatigue, weight loss, etc are common to both. However, patients with central adrenal insufficiency DO NOT have POSTURAL DIZZINESS & SALT CRAVING which are seen with primary adrenal insufficiency
This is because patients with central adrenal insufficiency do not have mineralocorticoid deficiency unlike those with primary adrenal insufficiency. Salt craving and orthostatic symptoms are generally due to mineralocorticoid defects. #endotwitter #ClinicalPearl
In Primary adrenal insufficiency, the loss of the mineralocorticoid function proceeds the loss of glucocorticoid function. Mineralocorticoid axis can be tested by measuring the plasma renin level. The elevation of plasma renin occurs before the fall of cortisol. #ClinicalPearl
Read 3 tweets

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