Discover and read the best of Twitter Threads about #FOAMed

Most recents (24)

A patient comes in with joint pain, fever, and the skin findings below. They recently finished a course of antibiotics.

Diagnosis? Name of the skin findings?

#dermtwitter #medtwitter #meded #FOAMed ImageImage
Nice work everyone!

The skin findings are keratoderma blenorhagicum (KB) and erythema nodosum, both findings that support the diagnosis of reactive arthritis.

Remember this is a seronegative spondyloarthropathy, usually after a gu or gi infection. Think hla-b27.
As @ZachHopkinsMD points out, there are more skin findings, such as mucosal findings in the oropharynx and in the genital region, & dactylitis (📸 is from psoriasis).

Don’t forget the board exam mnemonic:

Can’t pee (urethritis)
Can’t see (uveitis)
Can’t climb a tree (arthritis) Image
Read 3 tweets
You may have heard of the recent spate of hospitalizations linked to Daily Harvest ready-to-eat lentil/leek crumbles.

The exact cause remains a mystery, but several theories are swirling around. I'd like to explore a few of them. (1/n) 🧵⬇️

#ToxTweets #FOAMed #MedTwitter
Anecdotal reports on Twitter and Reddit share common elements. People:

1) Ate the lentil crumbles;

2) Rapidly developed severe stomach pain, dark urine, itchiness;

3) Had symptoms/labs consistent with acute liver failure (ALF) on hospitalization. (2/n)
The product has since been voluntarily recalled, and the FDA is currently investigating potential causes. Most speculation currently centers around a few possibilities:

1) Lectins
2) Aflatoxins
3) Other Pathogens

I'll mainly focus on the first two for this thread. (3/n)
Read 26 tweets
1/Do radiologists sound like they are speaking a different language when they talk about MRI? T1 shortening what?T2 prolongation who?
Here’s a translation w/a #tweetorial introduction to MRI
#medtwitter #FOAMed #FOAMrad #medstudent #neurorad #radres @MedTweetorials #neurosurgery Image
2/When it comes to bread and butter neuroimaging—MRI is definitely the butter. Butter makes everything taste better and packs a lot of calories. MRI can add so much information to a case Image
3/In fact, if CT is a looking glass into the brain—MRI is a microscope. It can tell us so much more about the brain and pathology that affects the brain. So let’s talk about the basic sequences that make up an MRI and what they can show us. Image
Read 22 tweets
🤷‍♀️ ¿𝘿𝙤́𝙣𝙙𝙚 𝙘𝙤𝙡𝙤𝙘𝙖𝙢𝙤𝙨 𝙡𝙤𝙨 𝙚𝙡𝙚𝙘𝙩𝙧𝙤𝙙𝙤𝙨 𝙚𝙣 𝙡𝙖𝙨 𝙢𝙪𝙟𝙚𝙧𝙚𝙨? ¿𝙀𝙣𝙘𝙞𝙢𝙖 𝙤 𝙙𝙚𝙗𝙖𝙟𝙤 𝙙𝙚 𝙡𝙖 𝙢𝙖𝙢𝙖 𝙞𝙯𝙦𝙪𝙞𝙚𝙧𝙙𝙖?

Te cuento en este hilo 🧵

#urgencias #emergencias #electros #ecg #ekg #FOANed #FOAMed #electrodos #electrodes #woman
Esta es la eterna pregunta que ya se planteaban en 1954, cuando la Asociación Americana del Corazón, @American_Heart, comenzaba a estandarizar dónde se colocaban los electrodos. (En la foto la publi de 1954. Aunque realmente la primera publicación data de 1938).
@American_Heart Allí determinaron que si hay mamas grandes, se colocan los electrodos debajo de la mama, desplazándola hacia arriba para que el menor tejido mamario posible esté entre el electrodo de exploración y el corazón.
Read 12 tweets
It's overdue. Time for a #dermtwitter #tweetorial on...

SEZARY SYNDROME!

We're going to focus on presentation and work up!

#sezary #ctcl #medtwitter #onctwitter #meded #FOAMEd
1/
Just a few years ago, Sezary Syndrome (SS) was thought to be the leukemic variant of Mycosis Fungoides (MF). We basically thought people had MF, it would keep getting worse, and then it would turn into SS.

Check out my old #tweetorial on MF here👇
2/
But patients often present with either the classic SS exam (red all over, super itchy), or with MF. Some patients would progress from MF--> SS, but it's the minority. So it became clear these are two different processes.

For that reason, we've changed how we think about it...
3/
Read 17 tweets
1/Understanding cervical radiculopathy is a pain in the neck! But knowing the distributions can help your search
A 🧵to help you remember cervical radicular pain distributions #medstudenttwitter #medtwitter #radres #FOAMed #FOAMrad #neurorad #Meded #backpain #spine #Neurosurgery
2/First, a rule of thumb—or rather a rule of elbow! You have 10 fingers. If you divide that in half, you get 5. Similarly, if you divide your arm in half at the elbow, you get 5--C5 that is! C5 radiates towards the elbow. So if it radiates below this, it is > C5 & above is < C5
3/So let’s start with C2. C2 predominantly radiates along the dorsal aspect of the scalp, as it supplies the greater occipital nerve. I remember this bc the number 2 has a swan like neck that mimics the contour of the back of the head and its distribution
Read 9 tweets
Here’s the Chest X-Ray of a young man who was rushed to the ER by paramedics

BP: 60/40
HR: 140
RR: 35
SPO2: 88%

What’s the diagnosis?
If you’re a new follower I always post the answer with explanation the next day. If you’re new to my account—follow me if you want to learn about medical emergencies
Here’s a video I made breaking down the Chest X-Ray from this important case

#FOAMed
Read 3 tweets
If you're bored and want to hear a debate about #C-collars, #spinalcordinjury, #CPR, #handsonlyCPR, #resuscitation, I and a bunch of medical colleagues at #ILSF, the International Life Saving Federation, are having a #Medical Committee members debate.
Good for #lifeguards, #surf #lifesavers, #paramedics, #firstresponders, #FOAMed, #medtwitter

For more information on each session - lnkd.in/dCJZAutS
Free registration via the following links:
Medical: cutt.ly/ZJptJxH -

Registration is free, numbers are limited.
“Commencing on the 28 June 2022 the International Life Saving Federation’s Rescue Commission will be hosting a series of webinars for the global lifesaving community.
Read 6 tweets
1/Radiologist not answering the phone?Just want a quick read on that stat head CT?

Here's a little help on how to do it yourself w/a #tweetorial on how to read a head CT!
#medtwitter #FOAMed #FOAMrad #medstudenttwitter #medstudent #neurorad #radres @MedTweetorials #neurosurgery Image
2/In bread & butter neuroimaging—CT is the bread—maybe a little bland, not super exciting—but necessary & you can get a lot of nutrition out of it. MRI is like the butter—everyone loves it, it makes everything better, & it packs a lot of calories. Today, we start w/the bread! Image
3/The most important thing to look for on a head CT is blood. Blood is Bright on a head CT—both start w/B. Blood is bright bc for all it’s Nobel prizes, all CT is is a density measurement—and blood is denser (thicker) than water and denser things are brighter on CT Image
Read 20 tweets
📌How to design a brain 101🧠🏗️

A 🧵 on how I use @powerpoint to create illustrations

🎨Key tools and my 2 secret weapons:

-@gboulouis adding "advanced" stuff
-@MVarkanitsa reviewing every little detail

#MedTwitter #MedEd #NeuroTwitter #NeuroRad #Neurology #neuropath #FOAMed
This 🧵 is inspired by a great recent post from @teachplaygrub, since we are using similar methods and tools on #PowerPoint!

🛠️ The Basic Toolkit:
-curve function ➰
-edit points function✴️
-Layering 🃏
-Zooming (x300-400%) for details 🔍

🎨 colors, shadows, 3D effects etc., depends on individual's style

1/
Read 15 tweets
1/Like a bad piano player in a run down bar--I take requests! By popular demand, a🧵on how I make those illustrations for my #tweetorials--all in #PowerPoint!
This one shows how to create shadow & highlights to give a 3D effect
#medtwitter #MedEd #FOAMed #powerpointpresentation Image
2/Let's use this french fry illustration I used for my varices🧵
I use the curve function to create shapes. It has the most control for drawing--the freeform function causes uneven lines.
After drawing the shape, I use the shape fill function to fill it in it w/the color I need Image
3/ 3D effects begin w/the gradient fill. I use the gradient fill that powerpoint offers for my selected color--it knows how to chose them so that the gradient is smooth Image
Read 10 tweets
1/As my attending once said, “If I’ve seen it once, I’ve seen it…well once.”
A 🧵about an interesting case that I’ve seen once in 15 years and never again. #medtwitter #radres #FOAMed #FOAMrad #neurorad #Meded #Neurosurgery #HNrad Image
2/Pt with history only of diabetes came in with altered mental status. There were these super bright round balls in their ventricles. It looked like a snowman massacre happened, with big round snowballs in the ventricles Image
3/On MRI, these had intrinsic T1 hyperintensity w/chemical shift artifact--they looked like boba tea pearls floating in the ventricles. Typically, we think of chemical shift w/fat--but these were not fat on the CT!! They did not enhance & otherwise, brain was unremarkable for age Image
Read 4 tweets
1/ Is the voice box a black box for you?! Let's open the pandora's box of the anatomy of the #larynx together

An introductory #tweetorial on laryngeal #anatomy and the supporting structures. #FOAMed #medtwitter #meded #neurorad #HNrad #FOAMrad #medstudenttwitter @MedTweetorials
2/Everyone needs some support. Just like the tongue is supported by the hyoid, the main laryngeal support is the cricoid cartilage. It's like your favorite chair, with all the remotes next to it--not only does the cricoid provide support, it also connects structures in the larynx
3/ Although not official, the cricoid is like the real first ring of the trachea. Except it has an odd signet ring shape. The bulbous back part that makes it look like a signet ring provides the important articulation with the arytenoids
Read 11 tweets
1/Mike Tyson once said, “Everyone has a plan until they get punched.”
In honor of all the great hooks and crosses—here is a #tweetorial about mandibular fxs! #FOAMed #medtwitter #Meded #neurorad #HNrad #FOAMrad #Medstudenttwitter @MedTweetorials Image
2/A key concept in these fxs is dental occlusion. The jaw is meant to chew. To crush food, teeth need to come as close together as possible—occlusion. Each tooth needs to meet up with its counterpart that fits with it, so no room is left for food—and food will be crushed. Image
3/Occlusion can be lost w/a fx. The importance of dental occlusion makes mandibular fxs different from other fxs. Usually, we want to fix a bone so that it lines up again. But for the mandible, we want to fix it so the TEETH line up again—so chewing will work. Image
Read 14 tweets
ICU/CCU/Pharmacy pearls: Adenosine is another one of my favorite drugs (again: no COI); who doesn’t want to walk into a patient’s ward room after a rapid response is called for a HR of 190/min, administer 6 mg of adenosine and head back to the ICU 10 min later leaving the patient
on SR 80/min and the ICU charge nurse relieved that she will not have to find a creative way to “open up” another ICU room. Adenosine push is one of the VERY FEW intensivists’ triumphant moves, so I will take it. Nevertheless, there are a few things about adenosine use
that I think are fun or good to know (there are probably more than few, I just don't know them!):
1. Adenosine is a natural substance formed by the degradation of adenosine triphosphate (ATP); yes, that ATP! So, in theory
Read 14 tweets
With Memorial Day behind us, we're getting into the summer months, so time for a #tweetorial on:

SUNSCREEN!

While #dermatologists are the usual ones who are making these recommendations, I hope this #dermtwitter/#medtwitter 🧵can help everyone!

#MedEd #FOAMEd #sunscreen
1/
First of all, I have no COIs with any makers of sunscreen! Even so, I'm going to avoid talking about any brands. Instead, we'll focus on the different factors you should consider when picking your favorite.

What is your current preference for sun protection (if any)?
2/
There's debate in the field right now about whether everyone even needs sunscreen. For this #tweetorial, I'm going to focus on those who've decided they need sun protection.

So 1st rec: The best sunscreen is one you'll actually put on. Doesn't matter if you won't use it!
3/
Read 18 tweets
1) Welcome to an #accredited #tweetorial on optimizing the use of #SGLT2i in the management of #T2D. This program is accredited for 0.50 🆓credits for #physicians #nurses #physicianassociates #nursepratcitioners #pharmacists by @academiccme! I am @tmodarressi of @HeartDoctorNJ.
2) This program is intended for healthcare professionals and is supported by an educational grant from Boehringer Ingelheim Pharmaceuticals Inc. and Eli Lilly Company. See archived programs, all by expert authors, still available for credit at cardiometabolic-ce.com.
Read 47 tweets
1/CSF leaks are controversial Some say they are overdiagnosed, others underdiagnosed. How can you make sure you aren’t under or over diagnosing?
A #tweetorial about a brain MRI score for suspected CSF leaks #medtwitter #FOAMed #radres #neurorad #FOAMrad #csfleak @medtweetorials
2/
With CSF leaks, everyone knows about brain sagging. But this can happen w/other pathologies, ie Chiari 1. Other findings can be seen on brain MRI in CSF leaks. But what are these findings? Are some findings more suggestive than others? Do more findings = ⬆️suspicion?
3/Dobrocky et al. looked at 9 quantitative & 7 qualitative signs seen on brain MRI in CSF leaks to see which are most important. Depending on type & # of findings, they developed a score to indicate what level of suspicion you should have for a leak.
pubmed.ncbi.nlm.nih.gov/30776059/
Read 12 tweets
Here’s an important ECG of a 30 year old man who presented to the ER with chest pain. This tracing was recorded just minutes before he collapsed into cardiac arrest.

What’s the diagnosis? Image
If you’re a new follower I always post the answer with explanation the next day. If you’re new to my account, follow me if you want to learn about Emergency ECGs
Here’s a video I made breaking down this very important #ECG case of a 30 year old man who collapsed into cardiac arrest.

#FOAMed
Read 5 tweets
1/10 We often talk about evaluation of AKI in the context of ⬆️ creatinine, but let’s take a step back and think about eGFRs. Here is an approach to interpreting ⬇️ in eGFR! #NephTwitter #MedTwitter #FOAMed #MedEd
2/ This differential focuses on the estimated GFR (eGFR), which is calculated using serum creatinine +/- serum cystatin C levels (we will take a look at the equations in a bit). Biomarkers that actually measure GFR (such as inulin) are not clinically practical to obtain.
3/ Thanks to @ZacNephron for explaining GFR vs eGFR, referring me to Chapter 2 of @BookBurton, and sharing this thread to deepen my understanding of the utility of GFR:
Read 11 tweets
1) Welcome to a new #accredited #tweetorial on Clinical and Laboratory Manifestations of #DKD in #T2D: From Early Identification to Monitoring Management. Your expert author is @edgarvlermamd.
2a) This activity is supported by an independent educational grant from the Boehringer Ingelheim/Lilly Alliance and is intended for healthcare providers. It is accredited for #physicians #physicianassistants #nurses #NPs #pharmacists. Check out @cardiomet_ce for more🆓CE/#CME.
Read 45 tweets
A brief thread on the #dermatologic exam for #monkeypox!

Caveat: I myself have not seen a MPX patient, but am piecing information together for my #dermtwitter and #medtwitter colleagues!

#MedEd #FOAMEd #tweetorial

PC:npr.org/sections/goats…
1/
Since #Monkeypox seems to transition from:

Macules ➡️ Papules ➡️ Vesicles ➡️ Pustules

The primary lesion isn't enough to make the diagnosis. You're going to need the primary lesion AND time from rash onset to know what you should be expecting to see.
2/
The prodrome that occurs before the rash includes the typical ILI type symptoms of fever, malaise, headache, pharyngitis, and cough. Lymphadenopathy has been billed as a distinguishing feature of MPX from smallpox and Varicella.
3/
Read 10 tweets
1/
Everyone loves those pretty colored fMRI pictures with the blobs. But what do they mean? How do they make them?
A #tweetorial called “F— that: Understanding fMRI”. #FOAMed #medtwitter #Medstudenttwitter #neurotwitter #FOAMrad #neuroradiology #radiology
2/
fMRI is based on a principle called “neurovascular coupling.” This is the principle if there is increased neuronal activity in a region, there will be increased blood flow to that region to meet the increased demand
3/
Think of it like a baby crying because it is hungry—parents immediately rush to feed it. The increased oxygen demand of the neurons immediately brings increased fuel to feed it.
Read 17 tweets
Writing an #ECG talk for @ICEM2022 and couldn't find an algorithm for approaching the "fixed" regular narrow complex tachycardia. Thought I would create my own.

#FOAMed @acemonline
@ICEM2022 @acemonline All this talk about VT versus SVT and it seems no one talks about an approach to regular narrow complex tachycardia.

Well, basic principles. Regular narrow complex tachycardias are either re-entrant, automatic, or due to triggered automaticity. (1)
Those due to re-entrant circuits include atrial flutter, AVNRT, orthodromic AVRT, and some focal atrial tachycardias. These are paroxysmal, have a fixed rate, and all respond to electricity (2)
Read 10 tweets

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