Discover and read the best of Twitter Threads about #TipsForNewDocs

Most recents (24)

ADHF with overload is the most common cause of admission in the United States.

Confident diuresis is a skill set all IM interns must master.

Follow these tips to take your inpatient diuresis to the next level!

~ Diuretics 201: A Thread ~

#tipsfornewdocs #MedEd

1/18 Image
Check out the @pointofcaremed podcast episode on this topic.

Here's a TL;DR for the episode

When Admitting:

Immediate strict I/O's

Double the patient's home dose of loop diuretic (maybe more in CKD)

Find out if the patient put out well after the first dose in the ED (might not have the best I/O data)

Continue spironolactone if home med (to prevent hypokalemia)

Read 21 tweets
A 29-year-old male presented with a 6-month history of progressive painless skin lesions over his face, back, trunk, and limbs. He had no systemic symptoms such as night sweats or weight loss.
Skin biopsy showed diffuse dermal infiltrate with blast-like cells extending to the hypodermis. Immunohistochemical analysis showed cells that were positive for CD4, CD56, and CD123.
Read 4 tweets
Bone marrow examination suggested malignant bone marrow invasion. PET-CT scan showed extensive bone marrow invasion and malignant lymphadenopathy in the anterior mediastinum.
The correct diagnosis is Breast cancer.
Read 4 tweets
64yo woman treated for recurrent triple-negative breast cancer with chemotherapy and radiotherapy in 2014, with no evidence of recurrent disease for the past 7 years, presents with well demarcated erythematous skin changes and a focal necrotic wound.
Symptoms include skin pain, and her symptoms began with a documented COVID-19 infection.
Read 5 tweets
Diagram of embryonic development and characteristics of membrane anatomy under laparoscopy Image
It will probably redefine the surgical scope of complete resections of pelvic tumors (cervical, rectal, and bladder cancer), improve nerve-sparing and pelvic floor reconstruction, and reduce operative bleeding and surgical injuries.
Read 6 tweets
19yo woman who was 34 weeks pregnant presented to the emergency department with a 3-day history of abdominal pain. Physical examination revealed hyperpigmented macules on her lips and CT scan showed intussusception.
The diagnosis was Peutz–Jeghers syndrome
Read 5 tweets
A 4 month -old girl infant
▶️of consanguineous parents
▶️one of her brothers died at the age of 2 mth due to #SIDS with the other brothers being normal; presents with
▶️Dysmorphic features
▶️growth faltering
#MedTwitter #FOAMed #TipsForNewDocs
▶️Delivered by LSCS section at 38 wk gest due to intrauterine growth retardation.
▶️birth weight 1240 g, length was 37.3 cm , head circumference was 30.5 cm
▶️At the age of 12 days, she was admitted for suspected sepsis for a week and discharged in good general condition.
▶️Now at 4 months, severely growth retarded with normal mentality,
▶️weight 2.5 kg, length 47 cm ; head circumference 36 cm (all growth parameters below the 3rd centile).
Read 14 tweets
Have you all seen anything like this before..!?
What could this be?

#MedTwitter #FOAMed #TipsForNewDocs #MedEd Chest X-ray with posteroanterior and lateral view shows a pa
▶️A 57-year-old man of Javanese ethnicity, Indonesia, with a 12-year history of progressive shortness of breath on exertion
▶️there were inspiratory coarse crackles & occasional wheezing with⏬vesicular sound across all thoracic areas, more in the bilateral base of the lungs.
▶️Cardia was unremarkable, with observable clubbed drumstick appearance of the fingers, without cyanosis or peripheral edema
▶️heavy smoker, around 40 pack-years.
▶️previous h/o completed treatment of pulmonary Tb in 2018.
Read 14 tweets
A 4-week-old male infant born at 33 weeks of gestation presented with this. Observe the child's 👀 carefully ... what is happening to the eyes while its mouth opens and closes?
#MedTwitter #MedEd #TipsForNewDocs #Pediatrics #FOAMed
@Sthanu5 @AvrahamCooperMD @PaediatricFOAM
▶️The mother's pregnancy was complicated by maternal syphilis and methamphetamine exposure.
▶️The baby subsequently was found to have a positive serum RPR (1:4) & positive VDRL in CSF (1:1)
▶️GE - hepatomegaly & syphilitic rhinitis (snuffles)-
▶️Diag: Neurosyphillis
▶️Synkinetic jaw movement with blinking - Marcus Gunn jaw-winking syndrome, a congenital cranial innervation disorder wherein a usually ptotic eyelid elevates with mouth opening.
▶️Other names :- trigemino-oculomotor synkinesis and pterygoid-levator synkinesis.
Read 9 tweets
A 2 m old infant , born at 35 1/7 weeks of gestation via LSCS with BW 2610 g due to preterm PROM, came with sudden-onset bilateral buccal protrusions. NO trauma history previously, nor were any congenital disorders found.
What is this...!?
#MedTwitter #TipsForNewDocs #Pediatrics
▶️physical examination revealed bilateral protrusions that were normal in color & texture without bleeding, pus, or ulcer.
▶️With crying, the protrusions became more obvious..!
⚡️MRI showed lesions 2.9 cm in diameter over the left cheek & 2.7 cm over the right cheek with intact b/l buccinator muscle, presenting high signal in T1-weighted imaging view & low signal in fat-suppression view.
⚡️These were suspected to have extended from the buccal fat pad
Read 11 tweets
What is this?
A tattoo? Mehendi?

#MedTwitter #MedEd #TipsForNewDocs #FOAMed
It is called as "Lichtenberg figures", fernlike or featherlike transient skin injury induced by lightning. The girl was struck through the arm by which she was holding the rope.
Lichtenberg figures are pathognomonic of lightning injuries.
mech of injury can be a “direct strike,” which leads to fatal cardiorespiratory arrest, “ground current” when⚡️hits t ground nearby, “side splash” when⚡️strikes a nearby taller object, & “contact injury,” when t current is conducted by wires or otr metal surfaces, like this case.
Read 5 tweets
As an intern, one of the highest-yield schemas I learned was for persistent fevers despite treatment with abx.

I use it all the time as a resident, especially when working with cancer patients.

Let's go through it!

- Thread -

#MedTwitter #MedEd #FOAMed #tipsfornewdocs

The general ddx for persistent fevers in the hospital, despite abx:

1. Wrong bug
2. Wrong drug
3. Wrong process
4. No source control
5. Not enough time

Let's take them one at a time.

1. Wrong Bug

When giving abx, we assume it's bacterial, but after some time, you should also consider:

- viruses - ex: CMV, EBV, HBV, HCV
- fungi - ex: candida, aspergillus, PJP, etc
- atypical infections - tickborne, TB, etc.

Read 24 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
Providing basic life support is a core skill for all healthcare staff

#basiclifesupport #bls #FOAMresus #resuscitation
Read 13 tweets
Twitter allowed us to create something different in medicine. I think it's special for these reasons:
🔸Flattened hierarchies
🔸Low barrier to entry
Here's what I mean...
🔸Transparency = public accountability. Less locker room talk. Patients & the public hear us & engage, generally raising the bar for the conversation, bringing in diverse perspectives, and forcing some degree of professionalism. Unlike what we see in some closed groups on FB.
🔸Content focused; although amplification is a focus, the discussion is built on content. It's fundamentally different to build on words w images & videos rather than focusing entirely on the snippet. Twitter threads can be long and detailed with many refs/links... Unlike IG.
Read 9 tweets
Salter-Harris Classification:

Just remember SALTR (no E) for the Salter-Harris classification of growth plate fractures.

#TipsForNewDocs #MedEd #MedTwitter #medicine #medical #medicare #health #FOAMed #ClinicalPearl #clinicaltips #MedStudents

Read 5 tweets
Starting FY1 in a few weeks but terrified of radiologists?

Here's how to make great imaging requests:🧵

1) Know your patient and summarise effectively

If a colleague asks you to "just arrange a scan" and you aren't sure why...ask them!
2) Have a clinical question

"PE or not PE" is a much easier question for a radiologist to answer with a CTPA rather than "chest pain ?cause".

Radiologists can suggest the type of scan to best answer your question, with the lowest radiation dose.
Read 11 tweets
When should I send an ammonia? A thread 🧵 and list of indications

#MedTwitter #TipsForNewDocs
As I mentioned previously, ammonia is commonly sent for workup of AMS, and rarely is it helpful in that setting.

There are many reasons for this, one being ammonia needs to be sent from free-flowing samples and on ice. 🩸🧊

Also, it cannot be used to rule in or out hepatic encephalopathy, which is a clinical diagnosis.
Read 17 tweets

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