Discover and read the best of Twitter Threads about #ClinicalPearl

What is the Diagnosis?

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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

@medics_AbuSaif

Beautiful anatomy graphics from @medics_AbuSaif

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Read 24 tweets

Oren Gottfried, MD

@OGdukeneurosurg

Saline is a powerful surgical instrument. #neurosurgery #bleed #meded #clinicalpearl

Credit to this neurosurgeon

Craniotomy for Evacuation of acute subdural hematoma causing compression on brain. See primer on SDH from Netter.

Read 3 tweets

EKGDX

@ekgdx

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.

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#CardioTwitter

Criteria

✅ 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).

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#MedTwitter #ecg

CT form a real case with PE.

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#medicine #MedTwitter #MedStudentTwitter #ct #pe #ekgdx #ekg #ecg

ABCDE steps to Chest X-RAY Interpretation

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Chest X-RAY Interpretation 2

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Chest X-RAY Interpretation 3

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Read 8 tweets

@ManualOMedicine

Causes of acute pancreatitis

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Causes of Acute Pacreatitis

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Acute Pancreatitis – Causes, Pathology, Symptoms and Signs, Investigations, Management and Complications

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⚡️Nephrotic vs nephritic syndrome

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⚡️Nephrotic vs nephritic syndrome

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⚡️Nephrotic vs nephritic syndrome

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@PTFlashcards

Rheumatoid arthritis vs. Osteoarthritis /pt1

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@PTFlashcards

Rheumatoid arthritis vs. Osteoarthritis /pt2

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Osteoarthritis vs. Rheumatoid Arthritis

via stephbeggs part 1/2

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Salter-Harris Classification:

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

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Salter-Harris Classification

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@radiologistpage

Salter-Harris Classification
@radiologistpage /1

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@medictests

Pitting Edema Grading

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@drmiketodorovic

Causes of Oedema

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@thecurbsiders

Lower extremity edema differential diagnoses

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Read 6 tweets

Oren Gottfried, MD

@OGdukeneurosurg

50 yo female with progressive eye redness and loss of visual acuity. She has a h/o hypertension. Thoughts? #MedEd
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#sciencetwitter #brain #medstudenttwitter #medical

Neuro intact other than vision.

What is reason for redness, specifically?

Steven Chen 陳持威, MD, MPH, MHPEd

@DrStevenTChen

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 🧵
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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.
2/

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...

PC: nejm.org/doi/full/10.10…
3/

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

#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