@MedTweetorials

@MedTweetorials

@ilanajhalperin

@RishiDesaiMD

Lea Alhilali, MD

@teachplaygrub

1/Does PTERYGOPALATINE FOSSA anatomy feel as confusing as its spelling? Does it seem to have as many openings as letters in its name?

Let this #tweetorial on PPF #anatomy help you out

#meded #medtwitter #FOAMed #FOAMrad #neurosurgery #neurology #neurorad #neurotwitter #radres

2/The PPF is a crossroads between the skullbase & the extracranial head and neck. There are 4 main regions that meet here. The skullbase itself posteriorly, the nasal cavity medially, the infratemporal fossa laterally, and the orbit anteriorly.

3/At its most basic, you can think of the PPF as a room with 4 doors opening to each of these regions: one posteriorly to the skullbase, one medially to the nasal cavity, one laterally to the infratemporal fossa, and one anteriorly to the orbit

Read 18 tweets

Elliot Tapper

@ebtapper

WHAT is the deal with Milk Thistle?
WHY is it used to treat liver disease?
HOW does it work?
DOES it work?
ARE you ready for a #tweetorial?
🧵
#medtwitter #livertwitter

Milk Thistle, a history:
1⃣Use to treat snake bites (Dioscorides)
2⃣To carry off bile (Pliny the Elder)
3⃣Great for liver disease (1500's: Otto Brunfels)
4⃣In 19th Century 🇺🇸, the 'Eclectics' popularized herbology, especially milk thistle, for the liver

Fast forward to today:
1⃣Herbal supplements are a multibillion dollarindustry
2⃣A quarter of the population takes an herbal supplement
3⃣~5% of the US population is using Milk Thistle, including 12% of people with liver disease

What do they get out of it?

Read 12 tweets

Steven Chen 陳持威, MD, MPH, MHPEd

@DrStevenTChen

We're seeing more consult questions for this, and it's also garnering national attention, so let's take a brief moment in #tweetorial format to talk about:

XYLAZINE SKIN ULCERS!

#xylazine #MedEd #FOAMEd #dermtwitter #medtwitter

1/

What is Xylazine? It was created in the 70s as a veterinary anesthetic. As an analog of clonidine, it has similar effects as an alpha-2 agonist, leading to sedation, anesthesia, and euphoria in the CNS.
2/

Recently, Xylazine has entered the drug supply, moreso in certain cities, but increasingly everywhere. It is often mixed with fentanyl as a cutting agent, and can also be used on its own. It may be called Tranq, Zombie Drug, or anestesia de caballo (horse anesthetic).
3/

Read 12 tweets

Lea Alhilali, MD

@teachplaygrub

1/Remembering spinal fracture classifications is back breaking work!

A #tweetorial to help your remember the scoring system for thoracic & lumbar fractures—“TLICS” to the cool kids!

#medtwitter #radres #FOAMed #FOAMrad #neurorad #Meded #backpain #spine #Neurosurgery

2/TLICS scores a fx on (1) morphology & (2) posterior ligamentous complex injury. Let's start w/morphology. TLICS scores severity like the steps to make & eat a pizza:

Mild compression (kneading), strong compression (rolling), rotation (tossing), & distraction (tearing in)

3/At the most mild, w/only mild axial loading, you get the simplest fx, a compression fx—like a simple long bone fx--worth 1 pt.

This is like when you just start to kneading the dough. There's pressure, but not as much as with a rolling pin!

Read 13 tweets

Lea Alhilali, MD

@teachplaygrub

@SVINJournal

1/The 90s called & wants its carotid imaging back!

It’s been 30 years--why are you still just quoting NASCET?

A #tweetorial about carotid plaque imaging in collaboration w/ @SVINJournal!

Featuring this 🆓#openaccess article: ahajournals.org/doi/10.1161/SV…

@SVINJournal

@SVINJournal 2/Everyone knows the NASCET criteria: If the patient is symptomatic & the greatest stenosis from the plaque is >70% of the diameter of normal distal lumen, patient will likely benefit from carotid endarterectomy. But that doesn’t mean the remaining patients are just fine!

@SVINJournal

@SVINJournal 3/Yes, carotid plaques resulting in high grade stenosis are high risk.

But assuming that stenosis is the only mechanism by which a carotid plaque is high risk is like assuming that the only way to kill someone is by strangulation.

Read 25 tweets

cardio-met

@cardiomet_CE

@nationallipid

1a) Welcome to a live-tweeted, #accredited #tweetorial from @nationallipid #NLA23 in #Atlanta on advances in #hyperlipidemia management #LLT. Our expert returning faculty is Pam R. Taub, MD @PamTaubMD #cardiologist from @UCSDHealth

@MedTweetorials

1b) Dr. Taub is a clinician/scientist and is a frequent contributor to our #accredited programs. She is the founding director of the Step Family Foundation Cardiac Rehabilitation and Wellness Center at #UCSD.
#FOAMed #cardiotwitter @MedTweetorials #MedEd #lipids

2) This program is supported by an educational grant from Esperion Therapeutics & is intended for #HCPs. Statement of accreditation & faculty disclosures at cardiometabolic-ce.com/disclosures/. Earn 0.75 hr 🆓CE/#CME by following this 🧵!

Read 48 tweets

Lea Alhilali, MD

@teachplaygrub

1/Understanding cervical radiculopathy is a pain in the neck! But knowing the distributions can help your search
A #tweetorial to help you remember cervical radicular pain distributions

#medtwitter #radres #FOAMed #FOAMrad #neurorad #Meded #meded #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.

If you divide your arm in half, that's at the elbow, you'll also get 5--C5 that is! C5 radiates to the elbow. So if it radiates below this, it's > 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

cardio-met

@cardiomet_CE

@cardiomet_CE

1) Welcome to a 🆕#accredited #tweetorial from @cardiomet_CE! Earn 0.5hr 🆓 CE/#CME by following this 🧵. Our expert faculty is Sanjiv J Shah MD @HFpEF, Cardiologist & Director, Northwestern HFpEF Program (hfpef.org). Director of Research, @NMCardioVasc
#FOAMed

@HFpEF

1b) .@HFpEF will be sharing the algorithm he uses to treat #HFpEF based on evidence we have thus far and his anecdotal experience treating patients over the past 16 years in the @NMCardioVasc HFpEF Clinic.
#CardioTwitter #MedEd @MedTweetorials #HeartFailure

2) CE/#CMEcredit for #physicians #physicianassociates #nurses #nursepractitioners #pharmacists 🇺🇸🇨🇦🇬🇧🇪🇺.
Statement of accreditation and faculty disclosures at cardiometabolic-ce.com/disclosures/.
FOLLOW US for accredited programs in #cardiometabolic space delivered wholly on Twitter!

Read 34 tweets

Lea Alhilali, MD

@teachplaygrub

1/ “Say Aaaaaaah!” I was explaining to my resident how I remember tongue anatomy on imaging & he said, “You have to put it on Twitter!”

So here's a #tweetorial about how to remember tongue anatomy on imaging.

#medtwitter #radres #medstudent #FOAMed #FOAMrad #neurorad #meded

2/ When you look on the coronal plane at the tongue, the first thing you notice are two column like structures that look like a pair of jeans—genioglossus—or as I like to say “jean-ee-o-glossus.” Genioglossus is latin for jeans of the tongue, right? 

3/Right below the jeans are what look like a pair of clown shoes—the geniohyoid. So you see a pair of legs going right into a pair of shoes.

Read 7 tweets

Charles Milrod, MD

@CharlesMilrod

Picture this:

A patient presents with an enlarging neck mass, and you find this 👇 on your evaluation.

What’s going on? 🤔

A #tweetorial 🧵 1/8

To guide our thoughts, let’s start with two Hodgkin lymphoma (HL) facts-

1) Cancer cells can ⬆️ PD-L1, which interacts with T-cells’ PD-1 and ⬇️ immune activity

2) 🔑 Immune checkpoint inhibitors (ICIs) block the PD-1/PD-L1 interaction & have strong activity in HL 👇

🧵 2/8

Why do immune checkpoint inhibitors have such strong activity in HL? 🤔

🧵 3/8

Read 10 tweets

Lea Alhilali, MD

@teachplaygrub

1/Time is brain! So you don’t have time to struggle w/that stroke alert head CT.
Here’s a #tweetorial to help you with the CT findings in acute stroke.

#medtwitter #FOAMed #FOAMrad #ESOC #medstudent #neurorad #radres #meded #radtwitter #stroke #neurology #neurotwitter

2/CT in acute stroke has 2 main purposes—(1) exclude intracranial hemorrhage (a contraindication to thrombolysis) & (2) exclude other pathologies mimicking acute stroke. However, that doesn’t mean you can’t see other findings that can help you diagnosis a stroke.

3/Infarct appearance depends on timing. In first 12 hrs, the most common imaging finding is…a normal head CT. However, in some, you see a hyperdense artery or basal ganglia obscuration. Later in the acute period, you see loss of gray white differentiation & sulcal effacement

Read 13 tweets

Brian Skinner, PharmD, BCPS 🐘

@PharmDinDOworld

Here's suggestion number 7 for How to Use #ChatGPT in #Academia for #MedEd and #TwitteRx:

Sometimes getting the output you want is difficult and can take several back and forth discussions. Here's what I first sent ChatGPT to create the #Tweetorial

1/x

Not very specific, but I wanted to see where it would take it. Vague input allows #ChatGPT to drive the conversation, and is great for idea generation. I wasn't thrilled with the first response as it was quite boring and would have required me to break up the tweets. 😴

2/x

Draft #2 was MUCH closer to the goal, but had 2 big flaws. First, it recommended something it currently cannot due (access realtime data) and it was all a series of prompts.

3/x

Read 7 tweets

Lea Alhilali, MD

@teachplaygrub

1/”Tell me where it hurts.” How back pain radiates can tell you where the lesion is—if you know where to look!

A #tweetorial about how to remember lumbar radicular pain distributions.

#medstudenttwitter #medtwitter #radres #FOAMed #FOAMrad #neurorad #tweetorial #Meded

2/Let’s start with L1. L1 radiates to the groin. I remember that b/c the number 1 is, well, um…phallic. So the phallic number 1 radiates to the groin.

3/Let’s skip to L3 for a second. I remember L3 is to the knee—easy, it rhymes!

Read 8 tweets

Brian Skinner, PharmD, BCPS 🐘

@PharmDinDOworld

Today’s tip is a doozy, but also very meta. Why should I tell you how to use #ChatGPT when it can create a #Tweetorial about itself. Everything below is all AI-generated with no edits starting NOW!

Tweetorial: Using #ChatGPT in #MedEd and #TwitteRx! 🧪💊

1/16: Welcome to the world of #ChatGPT! 🌍 This AI language model can enhance medical and pharmacy education in exciting ways. Let’s explore how faculty can effectively leverage its power. #MedEd #TwitteRx

2/16: Prompt examples: 💡 “What are the symptoms of COVID-19?” 🦠 “How does insulin work in the body?” 💉 “Discuss the pharmacokinetics of amlodipine.” 📚 Use specific prompts to engage students and encourage critical thinking. #MedEd #ChatGPT

Read 19 tweets

Umair Khalid

@Umair2017

1/ 🔥Hot off the press🔥

Read our uptodate #review on revascularization of left main disease 👇

Areas of focus:
⭐️ Anatomy 👁️
⭐️ Physiology 📉
⭐️ Data 📰
⭐️ Guidelines 📜

📌PDF: bit.ly/438Upvu

#ACCEarlyCareer #CardioTwitter #ACCFIT #ACCCVFed #MedTwitter #Tweetorial

@MVarugheseMD

2/
@MVarugheseMD @BryanTanMD @GrahamRector @olamideMD @DrHaloot @WanLuxi
@mo_gad_md @MattDeshotels @JRH_MD @AzkaLatif1 @MTLeeMD @Yazan___Assaf @YKherallah @AKUGlobal @AkuCardiology @WKayaniMD @mirvatalasnag @Obisht

@AliAghaBCM

3/
@AliAghaBCM @jerin3590 @anmedhekar @owaisuhaq
@haddadin_faris @Ingeniero_TX @AlizaHussainMD @skianoush @JamalMaharH @dmahtta
@jia_xiaoming @skohMD @SalikNazirMD @john_suffredini

Read 5 tweets

PublicEnema/Fr.Malić(she/her)

@publicenema2

Let´s talk about: #Darmspiegelung #Vorbereitung
Mit einem Endoskop (biegsamer Schlauch,mit Lichtquelle und Kamera und eventuell Greifinstrumenten) wird der Dickdarm untersucht.
Damit die Darmwand richtig angesehen werden kann,muss der Darm frei von Stuhlgang sein.
#Tweetorial

➡️Untersuchung wird entweder bei Beschwerden und Risiko gemacht,oder kann Spiegelung auch therapeutisch für Entfernung der kleineren Polypen oder Blutstillung genutzt werden.

➡️Wochen vor Untersuchung benötigt man Einschätzung,Einweisung/Überweisung,Termin.Arbeitsunfähigkeit von 2-3d einplanen.
➡️Auf regelmäßigen Stuhlgang achten.
➡️Eine Woche vor der Untersuchung empfehlen Fachgesellschaften eine low-fiber Diät(ballaststoffarm)

Read 13 tweets

Steven Chen 陳持威, MD, MPH, MHPEd

@DrStevenTChen

@VisualDx

A #dermtwitter #tweetorial on the skin manifestations of:

SYPHILIS!

#MedEd #FOAMEd #medtwitter #syphilis @VisualDx

pc: en.wikipedia.org/wiki/Treponema…
1/

Let's go back to the basics. Syphilis is from an infection by the bacterium Treponema pallidum. Usually spread by sexual means, syphilis has three main stages of disease.

Primary infection usually presents as a papule that turns into a painless ulcer called a chancre.
2/

Time from inoculation to chancre usually is 10-90 days (21 days is most typical).

There is a rare variant where the patient can get many smaller ulcerations, which is called Follman balanitis.
3/

Read 16 tweets

Zach London

@zach_london

What do inkblots and puppies hugging teach us about the way the long tracts are organized in the spinal cord? Everything.

Behold, our favorite tracts in the cervical cord.

A = fibers to/from the arm
T = fibers to/from the trunk
L = fibers to/from the leg

#tweetorial
1/7

Now let's just look at the arm fibers. For all three tracts, they are right up against the grey matter.

Want a #mnemonic to help you remember that?
2/7

Well, some say the grey matter looks like a butterfly.

You love butterflies, so what do you do when we see one? You hug it.

That's why your arm fibers are right up in there. For butterfly hugs.
3/7

Read 7 tweets

Lea Alhilali, MD

@teachplaygrub

1/Do you want a BASIC approach to skullBASE lesions?

My FINAL tweetorial on skullbase lesions—posterior skullbase & overall approach!

This #tweetorial will teach you to diagnose skullbase lesions by answering only TWO simple questions!

#medtwitter #meded #neurosurgery #radres

2/Remember, you can think of pathology at the skullbase like bad things that can happen while running. Bad things can get you from below—like falling into a pothole. They can come from within—like a sudden heart attack, or bad things can strike from above, like a lightning bolt

3/Same thing w/the skullbase—bad things can come from below, within, or above. Lesions from below are potholes tripping you up. Lesions from w/in the skullbase are like heart attacks strikning from inside. Lesions from above are the lightning, hitting the skullbase from above

Read 14 tweets

Lea Alhilali, MD

@teachplaygrub

1/Talk about the bases being loaded!

Central skull base has some of the most complicated anatomy & pathology in neuro

Do you know how to approach it?

Here’s a #tweetorial to show you how diagnose lesions at the central skullbase!

#meded #medtwitter #FOAMed #neurosurgery

2/Think of the skullbase divisions like different countries—each w/their own culture. Each division has lesions that are specific to it—just like countries have food that are specific to them.

I think the central skullbase looks like Italy, hanging down from the ant. skullbase

3/Lesions can involve the central skullbase from below, within, or above

Let’s start from below. Nasopharynx is below the central skullbase. Nasopharyngeal carcinomas (NPC) can invade from below

Using our Italy theme, you can remember this bc NPC look like an Italian meatball

Read 21 tweets

Lea Alhilali, MD

@teachplaygrub

1/It’s called the skullBASE but it’s anything but BASIC!

Does the sight of a skullbase lesion strike fear into your heart?

Never fear! Here’s a #tweetorial about a simple approach to these lesions that will change how you look at these cases

#medtwitter #meded #neurosurgery

2/Everyone fears the skullbase. It is so complex that not even experts can agree on a classification for the anatomy.

But you don’t need to know detailed anatomy to be able to give a differential diagnosis for a skullbase lesion that accurate & almost as importantly—short.

3/The skullbase is incredibly important. If you think of your brain as master or God of your body, then the skullbase is where the finger of God breathes life into the rest of you. All of the neuronal information from the brain travels through the skullbase to bring you to life

Read 23 tweets

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