Discover and read the best of Twitter Threads about #MedStudentTwitter

Most recents (19)

This week's #tweetorialsinpsychiatry is on suicide risk assessment in the ED (or indeed anywhere) and is predominantly aimed at non-psychiatrists and psychiatrists in training. I hope it is of help. #psychtwitter #medtwitter #medstudenttwitter #suicide #depression #psychosis
For additional reading around this tweetorial I recommend the following guide from the Oxford Centre for Suicide Research: cebmh.warne.ox.ac.uk/csr/clinicalgu…
and
ncbi.nlm.nih.gov/pmc/articles/P…
There are ~6000 suicides/yr in the UK (~47k in the US) of which ~90% have a psychiatric disorder. Depression accounts for 60%, Half have seen their GP within 3 months and 20% in the week before death.
Read 26 tweets
Enjoying our renal block right now. Thought I would try my hand at a #tweetorial for review and because this little pearl has been blowing my mind.

Why are people with nephrogenic diabetes inspidius, who are peeing lots, sometimes given a thiazide diuretic for treatment?
The answer is that while a thiazide diuretic would make you or I pee more, it will make someone with NDI pee less--so much less that it can be used to treat the polyuria that comes along with NDI.

To understand how, let's review the pathophys of NDI and the MOA of thiazides.
NDI is characterized by insensitivity of the kidney to ADH, aka vasopressin, the hormone that is secreted by the posterior pituitary and responsible for concentrating the urine.
Read 15 tweets
THREAD

I dove into the FEC data, and it's pretty clear:

Grassroots health professional donors far prefer Sanders and Warren to Biden and Buttigieg. 1/
For doctors, donations went mostly to Warren and Sanders, with Sanders slightly receiving more.

Buttigieg received a substantial portion.

Biden received very little.

#MedTwitter #MedStudentTwitter
@darakass @DrDooleyMD @AbdulElSayed @DrSriram @DoctorsforPete @Docs_4_Bernie To me this corroborates the polls which show that while medical trade groups/guilds/professional societies might not support policies like #MedicareForAll, grassroots doctors feel differently. 3/
Read 11 tweets
#medtwitter #tweetorial on one of my favorite, elegant little mechanisms. This is something every #resident and #medstudenttwitter will see ALL the time! Bonus inclusion: a simple way to think about macro/micro-cytosis.

So, why is basically everyone in the hospital anemic?

1/
Principles:

- it is useful to remember that the venous blood “drawn” for a lab test is composed of many parts: plasma, RBCs and WBCs.

- Hemoglobin (Hgb) is a direct measure of the actual Hgb molecule within the RBCs

&

- hematocrit (Hct) is the % volume of RBCs

2/
So why can we “cheat” and just multiply the hemoglobin by 3 to get the hematocrit?

Well - in a healthy RBC, approximately 1/3 of its space is a hemoglobin molecule!

So, imagine each RBC as just a Hgb molecule wearing a coat! The Hgb is 1/3 of the space, the coat 2/3s!

3/
Read 17 tweets
Hey #medtwitter and #medstudenttwitter! A while ago, I gave a #dermatology presentation on the intersection of derm and #trans health.

I learned a lot. So here's a #medthread on some of the takeaways I found most valuable.

1/10
Let's start with our transfeminine pts.

Derm can provide a number of facial feminization procedures (FFP): e.g. botox, soft-tissue augmentation.

These FFPs can be more affordable/less invasive than feminizing surgeries such as forehead or mandibular contouring.

2/10
Note: tho traditionally considered "cosmetic", these interventions have MATERIAL psychosocial benefits – studies show that facial feminization has a demonstrated positive impact on QoL + mental health outcomes.

3/10

ncbi.nlm.nih.gov/pubmed/26818277

ncbi.nlm.nih.gov/pubmed/20461468
Read 10 tweets
#tweetorial time for SUPER FAST, no WINTER or (difficult) MATH evaluation of Anion-Gap Metabolic Acidosis:

THE METABOLIC SEESAW. YEE HAW.

1/12
The metabolic seesaw:

dBC dAG
———————🔺———————
(more BC)

dAG = delta Anion Gap
dBC = delta Bicarbonate.
Toward the Center = more bicarbonate

This will all make sense in a moment.

2/12
Scene: patient w/ anion-gap metabolic acidosis

Your ?: is their compensation appropriate? Do I need more labs? Who and what is a winter and why do they have a formula?!?!

Answers: seesaw only, a chemistry is all you need!

3/12
Read 12 tweets
A last-day-of-pediatrics-clerkship thread.

#BuckleUp #MedTwitter #MedStudenTtwitter #Pediatrics

When my sister was 3 years old, my mom brought her to her general pediatrician for a regular well check.
She was a healthy appearing, curious and impassioned 3 year old. I wasn’t there but I imagine her pediatrician had to use the kind of magic only pediatricians have to get her to sit still for the visit.
I imagine that maybe he and my mom chatted casually about life’s happenings as he proceeded with the physical exam. I imagine that the exam was made challenging by my sister who was probably squirreling around, excited about the lollipop or sticker that awaited.
Read 11 tweets
1/
VENOUS STASIS LEG ULCERS!!!

A #tweetorial for the #dermtwitter, #medtwitter, #medstudenttwitter, and #hospitalist crowd. 📸:@dermnetnz #medthread

Let's start with a question - What percentage of leg ulcers do you think is caused by venous stasis?
2/
Roughly half (40-50%) of all leg ulcers are the result of venous stasis! Since 1% of the population will get stasis ulcers at some point, it's quite common, both in the inpatient & outpatient settings!

While some say they aren't painful, many of my patients would disagree....
3/
Let's talk exam. These ulcers are predominantly on the lower legs, and often near the medial malleolus. They're usually chronic, so they may have a base covered by yellow fibrinous debris. They tend to be shallow, and given the pathophysiology, quite exudative.
Read 15 tweets
CUTANEOUS LUPUS – a #tweetorial/#medthread!!

We all learn about Systemic Lupus Erythematosus (SLE) in medical school, but did you know there are multiple forms #lupus can take in the #skin?

#Meded #FOAMed #dermtwitter #medtwitter #rheumtwitter #dermatologia pc: @dermnetnz
1/
It wasn’t until #dermatology residency I learned about all the subtypes of cutaneous lupus (CLE)! I thought it was all just one disease: SLE. But in reality there are many forms of CLE, each with its own implications on systemic involvement and effect on the patient.
2/
Let’s start with the 3 subtypes:
Acute, Subacute, and Chronic Cutaneous Lupus Erythematosus (ACLE, SCLE, CCLE). CCLE is aka Discoid.
Each subtype "overlaps" with SLE in a different way.

Eg: ACLE overlaps completely with SLE, so they all have SLE! 👇
onlinelibrary.wiley.com/doi/abs/10.111…
3/
Read 17 tweets
There are many guides on how to write a personal statement. I thought I’d share my own thoughts for all those #premed & #medstudenttwitter folks. This is just my opinion, but it’s served me well.

So here goes: a #tweetorial on the PERSONAL STATEMENT!

#meded #medtwitter
1/
Unlike another recent #medthread on the PS, I don’t think we should be using it to scare our applicants or to expect that they entertain us. Applying for the next level be it med school, residency, or whatever is stressful enough! Let’s support our applicants through it!
2/
First of all, I think the PS when poorly written can definitely lose you an interview. When written in a super compelling way, it may tip you toward getting an interview, but in the vast majority of cases, it doesn’t move the needle much. So first rule: don’t get weird.
3/
Read 15 tweets
I’m a fellowship director who just finished reviewing over 400 applications for 8 fellowship spots.

The following is a #thread on writing a personal statements.
(Spoiler alert: I find 99% of them to be TERRIBLE.)

#meded
#medtwitter
#medstudenttwitter
1/
The following are MY preferences and proclivities. Some will ring true for other PDs, some may not. And Turi McNamee wrote very eloquently about this in @AnnalsofIM in 2012. pdfs.semanticscholar.org/94f4/4d6b3da42…
2/
I’m going to tag @davidschulman , @jennifer_jwm , @KristinBurkart3 , @DrMCMiles, @GenevaTatemMD, who are PD colleagues in #pccm, and @sanjayvdesai , @TKapetanos , @MitchGoldmanMD, @abbyCCim, @jenchoi_iu and any others who are PDs. I’d love to hear from them on this topic.
3/
Read 28 tweets
Here's another doozy. I want to dissect this tweet a little bit. If you are interested in the health disparities facing the transgender community, you should read this. 1/ #MedTwitter #MedStudentTwitter #Transgender #TransHealth #TransgenderHealth #LGBTQ #LGBTQHealth
Endocrinologist, @will_malone, has a history of cherry-picking data to support his idea of rapid-onset gender dysphoria (ROGD); a contentious idea based on one questionable publication with poor methodology: journals.plos.org/plosone/articl… 2/
This article has been cited by many as a means to discredit the trans community and speak against the current standard of care set forth by @wpath and many other professional medical societies - claiming it is child abuse 3/
Read 21 tweets
In 2001, I #failed 4 core science classes in #medicalschool. I didn’t go to class, I stayed up late at night reading the topics in every book I could possibly find. I barely passed my other courses. I couldn’t believe NEone passed..
1/
I had to go before the review and promotions committee and beg for a chance to try again. I don’t for the life of me see why they gave me the chance...

I can say, I tried hard, I just wasn’t smart about it.

In the summer before restarting m1, I came up with a plan..
2/
I approached each of the top 10% in the class I was now leaving. I asked them how they did it, down to the details on brands of pens, where they sat in class, what they ate, and when they went to bed.

Guess what...they were pretty uniform in their methods.
3/
Read 13 tweets
#MedStudentTwitter #IMResidency

It’s Personal Statement Season!

I help review med student statements and have a few thoughts to share to hopefully help students/faculty along the way.

Its a thread.

👉awesome PDs can chime in @carolinemilneMD @abbyCCim @CincyIM @AmyOxentenkoMD
1⃣Big Picture
The personal statement is an opportunity to weave together
* highlights from CV
* experiences
* personal attributes
Into a cohesive story that explains
- Why you are going into IM
- What you can bring to a program
#IM_PSTips
2⃣ To start, find your PS from your Med School Application

- Think about how you have grown since then...
- What experiences in med school helped you grow into the prepared student you are now ready for residency?

☑️ Write all of this down
#Reflect #growthmindset #IM_PSTips
Read 12 tweets
Alright, I have some thoughts on this op-ed, esp how tradition + legacy are often used as a distraction tactic from diversity/inclusion.

Buckle up for A THREAD.

#MedTwitter #SoMeDocs #DoubleDocs #DiverseDoubleDocs #MedStudentTwitter #WomenInMedicine #DiversityInMedicine
As always I start my thread by recognizing my own position in this conversation: I am a (proud) Latina woman training to be a physician-scientist. I hold a lot of privilege having attended an Ivy League institution for undergrad and currently training as a #DoubleDocs at another.
My own alma mater #PrincetonU has been recently grappling with its own (problematic) history by taking active steps to diversify iconography + naming around campus. I am proud to say that this is in part due to a meeting I co-hosted as co-president of PLA in combo with other orgs
Read 36 tweets
Experiences to seek during medical training: #MedStudentTwitter

Be present during a patient’s death. Watch how a patient dies. Don’t simply order “comfort cares” and sit at your computer. Be there. Hold the patient’s hand or that of a loved one. Some day it will be your own. 1/
Spend a day with an ICU nurse. Learn what patient care means. 2/
Chat with an elderly patient about their childhood, early adult life. People have amazing stories, and these stories may very well shape how you optimally care for the patient and their family. It may also shape you care for other patients and your own family. 3/
Read 9 tweets
Just got a #Step1 question wrong and I want to talk about it. The question asked about a pediatric patient who came in with RBC casts, facial puffiness, after having had a scabby-pustular rash a month prior...
I knew that this was likely post-streptococcal glomerulonephritis (facial puffiness = Na and H2O retention, casts = damage from immune deposition). I knew the rash was probably impetigo, which is mostly caused by staph aureus, but can occasionally be caused by strep...
I knew all of that and figured the most likely culprit was group A strep (s. pyogenes), which was correct. But that wasn't the question... The question was what characteristic the culprit bug would exhibit:...
Read 14 tweets
1/
#Dermatology #tweetorial time! Let's spend some time on the autoimmune blistering diseases. There are many, so this will be a broad overview of the approach to a the bullous disease patient.
#dermtwitter #FOAMed #medtwitter #medstudenttwitter #MedEd @healourskin pc:@dermnetnz
2/
The first ? we usually ask: "What is the level of the split?" That helps to distinguish between the #pemphigus group of diseases where the desmosome is involved in the epidermis, and the #pemphigoid group where the hemi-desmosome is involved at the basement membrane zone.
3/
This correlates with the exam! Higher up in the epidermis means a thinner walled blister that's more fragile. So these are usually flaccid bullae. Deeper down means tense bullae. Photo 1 is pemphigus - see how droopy the bulla is? Vs photo 2 of pemphigoid, which stands up.
Read 17 tweets
Mnemotecnias Médicas👩‍⚕️👨‍⚕️🌏🌍🌎

Abro 🧵iniciamos👨‍💻y abierto los comentarios

#FOAMed #FOAMped #medtwitter #Urgenciologa #Urgencias #MedStudentTwitter #Pediatrics #Pediatria #FOAMex #UCIP #UTIP #PedsICU #ENARM2019 #MIR2019 #FACMED
Son tres los objetivos, donde el principal, es compartir y fomentar el conocimiento útil en la práctica médica
Saber que puede usarse tanto nemotecnia como mnemotecnia según @RAEInforma
Read 38 tweets

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