Discover and read the best of Twitter Threads about #MedStudentTwitter

Most recents (24)

ICU stories (a boring one…): If you work in a general ICU of a community hospital in United States, one of the common admissions you will get is the unfortunate resident of a nursing home or rehabilitation center that lives there for several decades & at some point becomes
febrile/“altered” & is sent to the ED for “evaluation”. The course is so predictable that we usually consider these admissions “boring”. This is the case of a middle-aged pt w cerebral palsy/mental retardation/seizures (on valproic)/PEG-chronic Foley in place who was sent to
the ED for fever+hypotension+tachycadia. Labs: WBC 15k, lactate 4.0. UA -as usually- suggestive of UTI (WBC>50, +bacteria, +nitrite, +esterase). CXR “clear” & pt w sat 99% on room air. Received ivf, Abx (pip/tazo + vanco) but due to persistent ⬇️BP, norepinephrine gtt was ordered
Read 25 tweets
A 5-YO♂️ with a history of IgA vasculitis & a pustular nasal lesions had started scabbing after 2 days of systemic glucocorticoids: progressively painful skin ulcerations of L forearm (A), R calf (B) & R foot (C).
1/4

DOI: 10.1056/NEJMicm2204111
#Pediatrics #dermatology Image
Biopsy samples from all three lesions showed a dense neutrophilic infiltrate with negative tissue cultures.

PYODERMA GANGRENOSUM
2/4

#MedTwitter #Doctor #MedStudentTwitter
Laboratory & radiographic: no signs of underlying systemic disease, such as cancer, inflammatory bowel disease, or autoimmune conditions.

After 8 months of glucocorticoids: the lesions resolved completely.
¾

#resident #pediatric #MedicalStudents
Read 4 tweets
Vancomycin is primarily effective against Gram positive bacteria ✅

No/clinically insignificant activity against most of the gram negative bacteria.🦠

Because of the large molecular size, vancomycin cannot penetrate the outer membrane of gram negative organisms. ❌
Exceptions:

📍In vitro activity against certain nongonococcal Neisseria species 🧫

📍Elizabethkingia meningoseptica that causes meningitis in newborn and immunosupressed. Evidence regarding the use is not clear though. 💉

#pharmacology #MedStudentTwitter #MedTwitter
Screenshot from Classify Rx 📱 onelink.to/classifyp
Read 3 tweets
Are you a #juniordoctor or #medstudent?

Here's 10 great FREE modules to help get you started on the wards!

#meded #medschool #tipsfornewdocs #juniordocs #FOAMed #medtwitter #medstudenttwitter #juniordoctors #medstudents
Occasionally you'll need to perform sterile procedures. Make sure you prepare the best you can

osler.app.link/CztXIRjyntb
Providing basic life support is a core skill for all healthcare staff

osler.app.link/u4fe8uqyntb

#basiclifesupport #bls #FOAMresus #resuscitation
Read 13 tweets
It's December, already. The time of the year when I am trying to spend every last cent of the annual allowance given to us for continuing medical education (CME) by our employer. In essence, this is money that we have worked for and, since it won't carry over to next year, I hate
leaving it on the table. The problem is that if you buy a conference or a study course now, you have to watch everything - and submit proof of attendance/completion - before the end of the year. So, it's a very busy month dedicated to studying/reviewing educational material!
For example, I just finished watching the last one of the 93 lectures from The Hospitalist & Resuscitationist 2022 conference #HR2022. If you are an intensivist/internist/family medicine/EM physician, I have no doubt that u will find several pearls to bring back to your practice
Read 5 tweets
When the robot is high on steroids 🤖

#pharmacology #MedStudentTwitter #MedTwitter Image
Dexamethasone is a _____ acting steroid
Dexamethasone has no mineralocorticoid activity
Read 4 tweets
1/Tonsillar or peritonsillar abscess? That is the question! When you look at a neck CT, do you know which one to say?
A #tweetorial on #tonsillitis complications
#medtwitter #radtwitter #neurorad #radres #meded #FOAMed #FOAMrad #HNrad #medstudenttwitter #RSNA2022
2/First some anatomy. Palatine tonsils (or faucial to the cool kids) sit in the oropharynx between the two palatine arches: the palatoglossus arch in front and the palatopharyngeus arch in back. These are easily visible on physical exam.
3/These archs are actually just mucosa draped over the palatoglossus and palatopharygeus musculature, like kids drape sheets over themselves to dress up for Halloween.
Read 13 tweets
A 25-YO♂️ in Nigeria 2 years earlier: recurrent itchy swellings on his hands and forearms, appearing every week or so for the past few months.

What's in the #eye (A) & in the blood (B)?
1/4

doi.org/10.1016/S0140-…
#Ophthalmology #parasitology #microbiology ImageImage
Identification of:
📌an adult worm in the eye
📌the microfilariae on a blood smear

LOA LOA FILARIASIS is a skin and eye disease caused by the nematode worm Loa loa.
2/4

#parasites #MedEd #MedTwitter ImageImage
Loa loa is one of three parasitic filarial nematodes that cause subcutaneous filariasis in humans.
The other two are Mansonella streptocerca and Onchocerca volvulus (causes river blindness).
3/4

#Doctor #MedStudentTwitter #oftalmologia
Read 4 tweets
A 17-MO♀️, Morocco: fever, pallor, epistaxis, gingival petechiae, lower limbsedema, & hepatosplenomegaly.

Pancytopenia, hypoalbunemia.
Triglyceridemia, ferritinemia, LDH & fibrinogen:⬆️
PT⬇️
Direct Coombs test:➕

🔬myelogram: ?
1/9

#parasitology #haematology #Pediatrics
Myelogram revealed the presence of leishmania bodies and figures of hemophagocytosis.

VISCERAL LEISHMANIASIS ASSOCIATED WITH MACROPHAGE ACTIVATION SYNDROME
2/9

doi.org/10.1016/j.idcr…
#Pathologists #microbiology #IDtwitter
The patient was put on liposomal amphotericin B and corticosteroid therapy with good clinical and biological evolution.
3/9

#MedTwitter #Doctor
Read 9 tweets
A 63-year old man, kidney transplantation: fever and a painful ulcer on the lateral side of the tongue.

🔬: showed invasion of X?
1/8

doi.org/10.1016/j.idcr…
#OralPath #maxillofacial #nephrology
🔬 showed invasion of Cryptococcus neoformans.

A tongue swab:➕for HSV-1.

The cryptococcal antigen test on serum: ➕

CRYPTOCOCCOSIS TONGUE ULCER IN A RENAL TRANSPLANT PATIENT
2/8

#mycology #Pathologists #microbiology
A CT-scan of the lungs showed extensive ground glass lesions & a lesion of 4.7 cm in the left upper lobe.

Bronchoalveolar lavage:➕for Cryptococcus neoformans & Pneumocystis jirovecii.

LUNG COINFECTION OF C. NEOFOMANS & P. JIROVECII
3/8

#IDtwitter #MedTwitter
Read 8 tweets
Learned so much in this evening's @AACI_Cancer@ webinar on physician use of social media! Dr. @fumikochino highlighted sev successful research collaborations that began via #SoMe & said that Twitter has helped a lot with the "hustle" all #MedTwitter junior faculty face.
Dr. @SyedAAhmad5, who began tweeting during the #pandemic, highlighted opportunities to expand reach of #MedEd via #SoMe. For example, he taught this to #MedStudentTwitter, then realized there was no reason the learning needed to be confined to his operating room. cc @AACI_Cancer
Drs. @Jasosamd, @fumikochino, & @SyedAAhmad5 provided examples of using #SoMe to inform #MedTwitter, #SurgTwitter, & the pt #advocacy community about one's own research, as well as to promote the work of colleagues, esp mentees.
#mentorship #HeForShe #SheForShe
cc @AACI_Cancer
Read 10 tweets
1/ Let’s talk about PR Interval - Segment #CardioTwitter.

The PR interval represents the time between the onset of atrial depolarization and the onset of ventricular depolarization and reflects conduction through the AV node.

🧵by @ekgdx
2/ PR Interval

Criteria

✅ Normal PR interval: 0.12 - 0.20 sec.
✅ Prolonged PR interval: >0.20 sec.
✅ Short PR interval: <0.12 sec.

The term “PQ interval” is preferred by some EKG lover because it is the period actually measured unless the Q wave is absent.

#PR #interval
3/ The PR segment is the segment between the end of the P wave and the start of the QRS complex.

Criteria

✅ Normal PR segment: Usually isolectric.
✅ PR segment elevation: ≥0.5 mm.

PR segment elevation causes: Atrial ischaemia/infarction, myopericarditis, PE, others.

#ekgdx
Read 6 tweets
1/ Let’s talk about P waves #CardioTwitter.

The P wave is the first positive deflection on the EKG and represents atrial depolarization. The first half represents right atrial depolarization and the second half represents left atrial depolarization.

By @ekgdx Image
2/ Normal P wave

Criteria

✅ Axis: 0° to +75°.
✅ Amplitude (L leads): <2.5 mm.
✅ Amplitude (P leads): <1.5 mm.
✅ Duration: 0.08 - 0.11 sec. 
✅ Morphology: Upright in I, II, aVF and inverted in aVR.

#Pwaves #ecg #ekg #ekgdx #medicine #MedTwitter #MedStudentTwitter #basic
3/ Peaked P wave

The morphology is peaked with amplitude ≥2.5 mm, usually in II, III and aVF.

The peaked P wave is a typical characteristic of right atrial abnormality/enlargement. 

Causes: PE, COPD, congenital heart disease, pulmonary hypertension, normal variant, others. Image
Read 12 tweets
This is a Vesico-Vaginal fistula a condition that devastates d life of lacs of women, in India & in d west. VVF is an abnormal communication btw the bladder & d vagina, leading 2 continuous leak of urine without control. It often coexists with a ureterovaginal fistula.A thread🧵;
A fistula is an abnormal pathway btw 2 body cavities, lined by epithelium. In this case, it is between the Vagina & the Urinary Bladder. It can be caused by;
1.Pelvic Surgery
2.Obstructed Labour
3. Radiation treatment
4. Cancer
5.Trauma including sexual assault
6.Miscellaneous
Obstructed Labour used 2 be d most common cause in India,while in the west,it ws Pelvic Surgery. Today even in India,Pelvic Surgery is d most common cause.
Hw does d pt present?- Constant Urine leak frm d Vagina. When a large fistula is present, d pt may not visit d toilet at all
Read 16 tweets
An 81-YO👵, type 2 DM: malaise, fever & anorexia, with oral pain & odynophagia, yellowish-white, pseudomembranous lesions on the tongue (A)

#endoscopy showed multiple shallow ulcers with a white coating (B)
1/6

doi.org/10.1503/cmaj.2…
#emergency #gastroenterology #MedEd
Glossal & esophageal🔬: multinucleated cells with moulded, ground-glass nuclei

PCR & immunohistochemical staining of the specimens: ➕ for herpes simplex virus type 1 (HSV-1)

HERPETIC GLOSSITIS AND ESOPHAGITIS
2/6

#GIPath #IDtwitter #microbiology
Her hemoglobin A1c was 7.2%.

Doctors treated her with a 7-day course of acyclovir, intravenously because of her odynophagia, and the oral and esophageal lesions completely resolved.
3/6

#MedStudentTwitter #MedicalStudents
Read 6 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.

1/

#CardioTwitter Image
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).

2/

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

3/

#medicine #MedTwitter #MedStudentTwitter #ct #pe #ekgdx #ekg #ecg Image
Read 4 tweets
A 26-yo👩‍🦰, #sexually active, with 1 partner: right knee and metacarpal arthralgia, tenosynovitis and pustules on her hand.

CT: an abscess on her chest wall
1/9

doi.org/10.1503/cmaj.2…
#IDtwitter #MedTwitter #emergency Image
✔️Urine gonococcal nucleic acid amplification test (NAAT):➕
✔️🧫from the patient’s chest wall fluid:➖but
✔️16S rRNA with gene sequencing confirmed presence of Neisseria gonorrhoeae.

CHEST WALL ABSCEST WITH DISSEMINATED GONOCOCAL INFECTION
2/9

#microbiology #MolBiol
Her doctors treated her with incision and drainage and intravenous ceftriaxone 2 g/d. for 17 days after resolution of the abscess

If chlamydia infection has not been ruled out, chlamydia treatment with doxycycline for 7 days should be added.
3/9

#surgery #MedStudentTwitter
Read 9 tweets
🌓🤪 Pac-Man ate my visual fields!

50 year old person presents with sudden onset headache and seeing "pieces of things" on the R.
Visual fields look like this👇👇

➡️What's happening?

#MedTwitter #MedStudentTwitter #neurotwitter #MedEd #Neurology #EndNeurophobia #stroke Image
🗺️🧠 Where across the visual system is likely the lesion?
#Ophthalmology
⭕️ Which artery has to be implicated, if this presentation is due to an ischemic #stroke and the rest of the neuro exam is normal?
Read 7 tweets
Alcohol withdrawal syndrome: I don’t know if u have a similar experience in other countries (or other places in the States) but I've recently seen a big spike in alcohol abuse-related disorders, especially alcohol withdrawal syndrome (AWS). I'm obviously referring to severe AWS
that eventually will need to come to the ICU (if we have a bed available!). There are many fantastic, well-searched reviews on this topic but it may be hopefully interesting for some if I put “my way” out there & also for me to learn from your experience. Even though the focus
will be on the neuropsychiatric component, I believe it is quite important to highlight other parts of AWS management. To this end, I will use the assessment/plan “per organ” approach which is commonly used when we write progress notes here in US. Here it goes:
Read 26 tweets
1/One important aspect to stroke care is well... ASPECTS.😂

Here’s a #tweetorial to help you remember this basic #STROKE scoring system

#medtwitter #FOAMed #FOAMrad #medstudenttwitter #medstudent #neurorad #radiology #radres #neurology #Neurosurgery #CT #meded #neurotwitter
2/ASPECTS stands for “Alberta Stroke Program Early CT Score.” It is meant to replace gestalt-ing what percent of the MCA territory is infarcted. Instead, it uses a 10-pt score to semi-quantitate the amount of infarcted tissue in the MCA territory on non-contrast head CT
3/You can think of it as a scorecard for the MCA.

For each region of MCA territory NOT infarcted, the pt gets one point

So the highest score possible is 10, and lowest score possible is 0
Read 18 tweets
ICU stories: You get a call from outside 🏥 to accept a middle-aged pt w DM2/HTN/HLD/some type of solid Ca on chemo/obesity who presented to their ED w weakness/anxiety/"feeling cold". Vitals: BP 80-100, HR 130s (sinus tach), afebrile, Sat 100% on room air. Labs: WBC 13K, ...
... Lactate 5.2, creat 1.3. UA w some WBCs/bacteria. CXR clear. Norepi drip ordered but cancelled after BP improved to mid-90s, HR fell to 120s, & lactate ⬇️ to 2.5. What's your next step?
The discussion went like this:
Me: I will be happy to accept but I have no idea what we are treating. If it is sepsis, the source is unclear. And what about PE? Can you pls get a CT before sending?
ED: Sure, will do it. Thanks.
You go home & next am you learn that the CT showed:
Read 21 tweets
📍Hydroxyzine is a first-generation H1 antagonist

📌Sedative action is pronounced

#pharmacology #MedStudentTwitter #MedTwitter
📍Cetirizine is a second generation H1 antagonist

📌An active metabolite of hydroxyzine

📌Less sedative action when compared to hydroxyzine but has higher sedative action than most of the other second generation H1 antagonists
📍Levocetirizine is the active enantiomer of cetirizine

📌More potent than cetirizine and can be used at half the dose of cetirizine with lesser sedation
Read 3 tweets
Different types of skin lesions
#skin #meded #medtwitter #InnoMed
Primary and secondary skin lesions
#meded #MedTwitter
Read 3 tweets
They have opposite effect on potassium levels and balance out each other ✌️

#pharmacology #MedStudentTwitter #MedTwitter
Which of the following will cause hyperkalemia ?
Higher incidence of cough is seen with
Read 4 tweets

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