Discover and read the best of Twitter Threads about #MedEd

Most recents (24)

1/Pulmonary embolism is a commonly encountered condition; however, how comfortable are you with the acute diagnosis and treatment of the disease? Let's take a walk through the guidelines. #tweetorial #MedEd @VCU_PCCM @crit_caring_MD @lkbrath @PSinkam @AvrahamCooperMD @VCU_IMRes Image
2/ Venous thromboembolism is currently the 3rd most frequent acute cardiovascular syndrome encountered globally with an annual incidence rate ranging from 39-155 per 100,0000 population. bit.ly/3j4iP2s @michellebr00ks @cjchiu @mdlizs @mkashiouris @B_M_Wiese @ptfaddenMD
3/This chart by Rogers, Anderson, and Spencer found in the @EuroRespSoc guidelines displays predisposing risk factors for VTE based on odds ratios. Check out all the risk factors with an odds ratio >10! @DxRxEdu @rabihmgeha @CPSolvers @AdamRodmanMD @tony_breu @KevinSwiatek Image
Read 18 tweets
THREAD: 5 Things You Need to Know About PPIs

For many years, we've dissected the research on Proton Pump Inhibitors (PPIs) 🤔

This thread captures our publications on PPIs that can help you in clinical practice: ti.ubc.ca/?s=ppis

#MedEd #medsafety #DrugEvidence #GERD Image
2/6 PPI COSTS VARY CONSIDERABLY 💰

Even without differences in efficacy or safety between PPIs, costs can vary x 10. The cheapest in BC? Pantoprazole Mg 40mg or Rabeprazole 10mg. Most expensive: Dexlanzoprazole

More here: ti.ubc.ca/letter99

#MedEd #DrugCosts #GERD
3/6 RESPONSE IS VARIABLE

1 in 2 pts w/ acid reflux get symptom relief with a PPI (NNT~2) w/in 4-8 wks

Responders notice symptom relief w/in 1-9 days. If no relief in ~2 wks consider 🛑 PPI. Non-acid reflux doesn’t benefit from PPI

More here: ti.ubc.ca/letter99

#MedEd
Read 7 tweets
1/ 💭 Did I check the labs? I know they were fine yesterday. What should I say? 💭

As a supervisor, you need to make clear to your learners (1) the right answer is: “I forgot to check them”

And (2) your reaction will be: “No problem. Let’s check them now.”

#MedEd #MedTwitter
2/ Here is where we are in our journey through the #HierarchyOfTeachingSkills.

Remember that this first level of skills is all about #PsychologicalSafety.

Not judging your learners is key to this.

Find our previous threads @MedEdTwagTeam.
3/ I make sure I never judge my learners. But I DO evaluate them and hold them accountable.

To me, these are three different things.

Here is how I define these concepts 👇
Read 14 tweets
1/
Time for another #morphology #Derm101 series #tweetorial on the skin exam. Today, we'll cover:

DISTRIBUTION

How the location a rash occupies on the body might help us with the differential diagnosis!

#FOAMEd #MedEd #medtwitter #dermtwitter #medstudenttwitter #dermatology
2/
An important point to start:
Distribution is LEAST important in the skin exam. Primary & secondary lesions, configuration & scale are all better in informing our DDx.

I tell my learners that if confused about a rash, pretend it's elsewhere on the body & see if that helps.
3/
Also - throughout this #tweetorial, I will try to display skin disease in lighter & darker skinned patients side by side. Remember in darker skin, erythema is harder to see, so I hope this highlights the point!

A question: In tweet 1, what distribution is shown in the photo:
Read 18 tweets
Meniscus injury: a complete review.

1/15
@MedTweetorials @RosenelliEM
#MedEd #OrthoTwitter #Tweetorials
The meniscus function is two-fold. It increases stability by deepening the tibial surface and it aids in force transmission by increasing the contact area to spread force over a larger surface area. The meniscus is responsible for 50% of load transmission across the knee. (1)

2/
The lateral meniscus has a more circular shape than the C-shaped medial meniscus. The lateral meniscus covers a larger portion of the articular surface and is also more mobile than the medial meniscus. The medial meniscus is relatively immobile and is attached to the MCL.

3/15
Read 16 tweets
1/ Are you ready for another #CNCR tweetorial?

👏👏👏 to another amazing case with @cardionerds and @DrRachelGoodwin @Dr_Isang_MD @WBlackDoc from U Tennessee

Catch up on the episode here:
cardionerds.com/58-case-report… Image
2/ Pt was Dx'ed with constrictive pericarditis (CP) which is often a dreaded topic 😱

Fear not! Let's break it down & focus on the echo findings of CP.

👉🏽👉🏽 💯 tweetorial on RCM by @CBlumenthal2 & 🌟 #CNCR case of hereditary RCM from @DukeCardFellows
CN5 on Hereditary RCM. CNCR...
3/ First, let's review basic anatomy :

✅Pericardium contains all ❤️ chambers
✅Cardiac chambers are affected by changes in intrathoracic pressure b/c same pressure changes are transmitted inside pericardium
✅ Pulm vasculature, SVC/IVC are external to pericardium
Read 14 tweets
Anything I say to give hard-pressed doctors a well-deserved laugh, has a risk of making some of them angry.

But this will amuse not only to every doctor, but everyone who has a science degree, and indeed a many other people who have merely been to school

off-guardian.org/2020/06/09/sci…
At first I thought Twitter was being a wet blanket and opposing fun and frolics.

But then I noticed the yellow text, and Twitter is right - there are some people uneducated enough to fall for this nonsense.
So here is a short thread to rescue people who have been misled by the Koch Postulators.

#MedEd #FOAMed

In your opinion, infections are caused by what?
Read 32 tweets
1/

Have you ever a junior member of your team ask you a question, and you had NO IDEA what the answer was?

Like, literally no clue.
Racking your brain.
Nothing.

Nope, just me?

This week’s #MedEdTwagTeam #ClinicalTeaching topic: Humility.

#MedTwitter #MedEd Image
2/

On my first day as a senior resident, I was terrified that my interns would ask me a question that I didn’t know.
…And they did.

So I said, “I don’t know, let’s look it up.”

And, (not surprisingly) they appreciated that.
Me, admitting my limitations & offering to help.
3/ Honestly, this fear of not knowing things still plagues me.
I have a weird combination of confidence + imposter syndrome.

Some days I feel confident.
Other days I wonder why everyone else is so much smarter than me.

Why can't I remember the names of those famous trials?!
Read 16 tweets
1/ Hey #MedEd #FOAMed, here's Week 2 of my @BostonChiefs #AMReportDxRx Morning Report:

Once again, we pulled out salient features, created a PR, brainstormed a schema, and reviewed illness scripts. Final Dx was Babesia! Here are the takeaways:
2/ Had a small white board, so needed one PPT slide with the case presentation, then used the white board to process the data. This time had residents work on a hemolytic anemia schema solo before brainstorming as group. Here's what it looked like:
3/
What went well:
1. Giving residents time to work solo on framework, thanks @tony_breu!
2. Discussing importance of Bayesian reasoning

Ideas for improvement:
1. Include treatment pearls
2. Taylor content for medical students

#MedEd community, what has worked for you?
Read 3 tweets
Yikes: lots of #MedEd teaching but no time to tweet to #MedTwitter! Here's a thread of #postitpearls with @dukeemergency !
Read 23 tweets
I am feeling a lot of things right now about #MedEd and the way we give feedback to our professors.

Professors of #MedTwitter and friends of #MedStudentTwitter, can we chat for a second?

Thread 🧵
Let's start with a baseline fact that we have to acknowledge:

We're all trying.

Students are trying, professors are trying, administrators used to be both students and professors and in their own way, are trying.
I am a medical student. I love class, learning, and meeting professors. I have some fantastic mentors who are professors themselves.

I'm also a staunch advocate for the way I learn and the way others learn - curricularly.

And for equity and language in medical lectures.
Read 18 tweets
Once again the conversation has started about whether we should change the name “palliative care.”

I appreciate the rationale including points made in a recent @washingtonpost article.

Allow me to present a counterpoint.

A 🧵, with videos:

#hapc #pedpc #MedEd #scicomm

1/
Yes, fear of palliative care comes from an association in some people’s minds with death.

As many including @SoniaMKhunkhun @anandiyermd @ctsinclair have pointed out, that is likely a failure of education and due to a cultural fear of death itself, not palliative care.

2/
When we conflate the scary thing with something that can help with the scary thing we risk missing a big opportunity for support.

As I’ve said before, it’s like confusing the fire with the fire department:

3/

Read 11 tweets
1/ 💭 When should I show up? What if I answer a question wrong? Is my presentation too long? Where’s the bathroom? 💭

Sounds like a case of “New Rotation Jitters”

The Cure - Setting Expectations!

Literally, one of my favorite things 🤓

#MedEd #MedTwitter #MedEdTwagTeam Image
2/ Here is where we are in our journey through the #HierarchyOfTeachingSkills.

Remember that this first level of skills is all about creating #PsychologicalSafety.

If you want to see any of our previous threads, check out the @MedEdTwagTeam account. Image
3/ Setting clear and explicit expectations is a key teaching skill that will pay numerous dividends.

And like much of teaching, there is an art and a science. Image
Read 19 tweets
To make a successful rounds presentation (for med students and off-service residents): pick a topic that matters to you, NOT the favourite topic of the most intense staff person in the room, and discuss it from the lens of "this is what I will need to know." #medtwitter #MedEd
Ex: don't discuss the most controversial trials in the treatment of colon cancer, talk about colon cancer symptoms and screening, cancer syndromes, and surveillance post-treatment
Ex: don't talk about the steps of a parathyroidectomy, talk about calcium physiology, the differential of hypercalcemia, and hypercalcemia work up and acute management
Read 6 tweets
Does it have to take a national movement against racism for the discrimination BIPOC women face in medicine to be taken seriously?
Does it have to take a national movement for “all these disparities women face in the workplace are worse for intersectional women” to move from a one-liner in #DEI work to the forefront and for #SystemicRacism to be relevant in the women in medicine movement?
When Black women spoke up about the discrimination we face and asked for allies to hold systems and institutions accountable, why is our go to answer “academia takes time?”
Read 8 tweets
Committed to ending racial health inequities?

You need to be talking to your patients about their civic health.

Voting and health inequities are closely linked.

Thread.
#MedTwitter
#MedStudentTwitter
#MedEd

(1/)
Families separated at the border
Another school shooting
#COVID19’s racist impact
The ongoing fight for #Medicaid
#ClimateChange

All impact the health of our communities. Outcomes that are heavily influenced by participation in, or lack of, voting.
#VoteHealth #VoteKids (2/)
Although we know policies directly impact health we see gaps in opportunity not only for access to resources but to the ballot box where many of our communities’ decision makers are selected.
(3/)
#VoteHealth #VoteKids

tcf.org/content/report…
Read 21 tweets
🔆Decision Algorithm for prescribing #SGLT2i #GLP1RA in #DKD

Ref-CJASN
doi: 10.2215/CJN.02690320
#NephroNotes #Nephpearls #FOAMed #MedTwitter #MedEd ImageImage
🔆Strategies to ⬇️adverse events in #SGLT2i #GLP1RA

💡Keep genitals dry & clean
💡Prophylactic topical antifungal
💡⬇️Diuretic dose
💡Pt education-"STOP DKA" Protocol
💡Self foot examination
💡Monitor PTH/VitD

doi: 10.2215/CJN.02690320
#NephroNotes #Nephpearls #FOAMed #MedEd Image
Read 20 tweets
1/
HOW does gabapentin work?
DOES gabapentin work?
WHY is gabapentin so shady?

Join me for a #tweetorial?

Keywords: Glutatmate, Asterixis, Alcohol-use disorder
#livertwitter #MedTwitter #meded
2/

Admitting a non-#cirrhosis patient with gabapentin overdose as an intern, I saw asterixis

This 🤯

If it caused asterixis (throwback: ), did that mean it causes HE?

Gabapentin has confused me ever since
3/
Everything about gabapentin is🍌
What follows is no different

There once was a💡dream💡 of using GABA signaling 2 prevent seizures. Yada yada yada, we made GABApentin. It approved in 1993!

Just one prob:
GABApentin doesnt bind GABA-receptors!

Like I said…🍌
Read 13 tweets
#IdBoardReview 65 M presents w/ severe pain in leg for few hours, progressed to rapid swelling/bullae and +gas on X-ray. hx of bright blood per rectum for few months. diagnosis? #idmedEd #medEd
#Clostridium septicum spontaneous non-traumatic gas gangrene associated with malignancy likely colorectal CA in this case
Spontaneous traumatic gas gangrene is most commonly due to Clostridium perfingens & sometimes other clostridia sp. Non-traumatic spontaneous gas gangrene: most commonly due to C septicum: 80% malignancy related, most common CA are colon f/b hematologic
Read 10 tweets
1/ Mechanism: Lung + Brain Injury in #COVID19:
 
In the ICU w/ #COVID we are dealing w/ SEPSIS & ARDS…most of what goes wrong in the human body when it’s infected with SARS-CoV-2 virus is mediated by…

read on...
 
#medtwitter #medstudenttwitter #pulmcc #tipsfornewdocs #meded
2/ Injury from SARS-CoV-2 virus is mediated by how much swelling (inflammation) and blood flow abnormalities (clotting and bleeding) occur, it’s wise to review what we know about SEPSIS, ARDS, & the BRAIN.
3/ Lung pathology affect parallel disturbances in the brain (& liver) via endotoxin, TNF, hypoxemia, shock & coagulopathy, metabolic derangements, & medical therapy such as the mechanical ventilator itself & sedatives & analgesics.
Read 8 tweets
Oh

My

God

I _had_ given up annoying people, forever.

But this one is such a facepalm. And there is now online evidence of me completely failing to debug a numbers thing.

#MedEd #Foamed #cardiotwitter

All blame goes to @mshunshin for my relapse.
I told Matt I had read this paper and I was gonna get some of this eicosapentanoic acid stuff for my TGs.

Then he said, "don't bother, just look at Table 2"
So I looked up the EVAPORATE paper again, and thought the master was merely swatting the grasshopper aside.

"Good try, Matt, but it will be OK - they have an 'out'"
Read 63 tweets
1/
OK team, #tweetorial #3 in our #Derm101 series on the #dermatology exam. Today, let's discuss:

CONFIGURATION!

How primary lesions are grouped or shaped. Read on to learn more!

#dermtwitter #medtwitter #medstudentwitter #meded #FOAMEd pc:@dermnetnz @BrwnSkinMatters
2/
Since this is the 3rd installment in the #Derm101 series, remember that if you haven't already, you might want to check out the first two #tweetorials on skin morphology.

Primary Lesion:

Secondary Lesion:
3/
I think of configuration as how the primary lesion might be shaped or grouped. So this would include rashes that are:

Annular
Polycyclic
Serpiginous
Linear
Geometric
Agminate
Herpetiform
Sporotrichoid
Target/Targetoid (kind of)

What configuration was the rash in tweet #1?
Read 20 tweets
1/ What do #racism & #redlining have to do with inequities in #HIV outcomes?

Our new study just published in #ClinInfectDis examines neighborhood deprivation, race/ethnicity, and HIV viral suppression. Thread 👇🏾

#MedTwitter #MedStudentTwitter #IDTwitter

doi.org/10.1093/cid/ci… ACCEPTED MANUSCRIPT "Neighborhood Deprivation and Racia
2/ #Redlining in the 1930s involved racialized federal mapping of housing "desirability" (L) --> ⬆️💰 into White/affluent areas + systematic disinvestment in "undesirable" areas.

To this day, HOLC maps of urban areas like Omaha STILL align w/deprivation & racial segregation (R). An official U.S. Home Owners Loan Corporation (HOLC) map of Area Deprivation Index (ADI) map of the Greater Omaha Area, Racial Dot Map of Greater Omaha Area, demonstrating clear pr
3/ Omaha is among the most segregated U.S. cities. Our HIV clinic serves ~50% Black and Latinx pts, who disproportionately live in deprived neighborhoods.

We assessed neighborhood disadvantage using the ADI, outlined by @amyjhkind et al. in @NEJM.

nejm.org/doi/full/10.10…
Read 8 tweets
1/ Bias in Medicine – A 🧵

This week I was able to participate in a #BiasInMedicine curriculum @UCSFMedicine. Below are some of my favorite (paraphrased) quotes and insights.

CC: @gradydoctor @dereckwpaul @jbullockruns @ChaseTMAnderson @_HarryPaul_ @FutureDocs @Bob_Wachter
2/ Black Female MD:

“Me being present everyday is me advocating. Just being in this space is me speaking up.”

“Some identities that we have are out in the open. Others are hidden, such as certain disabilities. These can be sources of bias. This is important to remember.”
3/ Latinx Female Med Student:

“Don’t ever call the medical student ‘the medical student’”

“There are times when the #HierarchyInMedicine makes sense…graduated responsibility to keep patients safe. That doesn’t mean it has to translate into all aspects of training.”
Read 10 tweets

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