Discover and read the best of Twitter Threads about #Tweetorials

Most recents (16)

#MedThread Day 10 (sorta). I'm sure most know this, which is why I consider this #BreadNButterMedicine. But, if you follow along, you might learn a little history as well! Today, we are going to talk about Central Venous Catheters.
2/ If you had your choice of central line sites (no contraindications), what would you choose?
3/ 1st, why would you want to place a CVC?
🔹CVP monitoring
🔹Resuscitation
🔹Emergency venous access
🔹Inability to obtain peripheral venous access
🔹Repetitive labs
🔹Need for hyperalimentation, caustic agents, or other concentrated fluids
🔹HD
🔹and MORE!
Read 20 tweets
1/
Attempting some #tweetorials on urine electrolytes with the hope of improving my understanding & appropriate clinical utility of these tests. I welcome any and all feedback. Without further ado, lets get started. First will be urine sodium (UNa).
3/
From here on, Aragorn will be our patient.Just re-watched #TheTwoTowers so this name came to mind. While I enjoy Gimli & Legolas, there is not much literature on Dwarvish or Elvish physiology so I am forced to stick with the world of Men(though Dúnedain lifespan is quite long)
Read 27 tweets
Day 7 of my inpatient service & number 7 of my #BreadNButterMedicine #MedThreads.

Today, Hemodilution!

I’m no expert & I don't routinely administer large volumes of IV resuscitation fluids like my EM & trauma colleagues. But, I do give maintenance fluids to many patients.
2/ (POLL) With maintenance IV fluids, which cell lines can you see decrease due to hemodilution?
3/ To unpack this, we need to first start with the definition...

What is hemodilution?

Hemodilution implies dilution of the normal blood constitutents occuring either spontaneously after injury and/or blood loss, or as a result of plasma replacement or expansion.l
Read 17 tweets
Friday #Medthread! I’ve been chatting lately that I should write a #tweetorial about how I’ve put my social media related/based activities on my academic/professional CV. So, without further ado... 1/x
these are excited times, & hopefully this won't be uncharted territory for too much longer as standards are set and more institutions embrace social media related activities...BUT for now...how do you show your uniqueness and innovations via #medtwitter #SoMe?? 2/x
Disclaimers:
1⃣these are my opinions (grounded in experience & many discussions)
2⃣I use the OHSU CV template (Scholarship/Service/Teaching)
3⃣employers may not be ready to embrace

PS--bonus points--name the TV show the GIF is from!! (probably not known/respected enough...)
Read 18 tweets
Want to hear a joke?

What's bumpy & painful, & "read" all over?

A #tweetorial/#medthread on ERYTHEMA NODOSUM!

Now that I've lost a few hundred followers from that terrible opener😳, let's get started👇👇

#MedEd #FOAMEd #dermatology #dermtwitter #medtwitter pc: @dermnetnz
1/
Why talk about erythema nodosum (EN) in the first place? Well, most medical professional recognize it, will see it, but may need some help past that! If that's you, read on.
1st, exam: As the name implies- red nodules! It's usually on the legs, & they are often ill-defined.
2/
EN is commonly seen in young healthy pts, & women >> men. Of course, the patient's history is critical, as EN is a reactive process to something else! It's inflammation in the subQ fat (a panniculitis). The rash itself isn't dangerous, but should prompt looking for a trigger.
3/
Read 13 tweets
If the amazing, cutting edge, in-depth discussions on #EpiTwitter make you feel both *inspired and incompetent*

(out-of-your-depth, totally lost, etc)

Here is your reminder that this is TOTALLY OK!

👇🏻 #SendingToMyself 🧵
Not all methods/issues are relevant to everyone’s work so there’s no reason you should be fluent in all of Epi.

In fact, you can’t be.

What you can be is the expert that I know I can go to when I come across something new that overlaps with your area!
#EpiTwitter is not here to make you an expert on everything.

These discussions & #Tweetorials are here to give you an idea of when things you work on might go wrong and to let you know who can be your phone-a-friend when it does.
Read 6 tweets
My goal for these #Tweetorials is to empower you to apply engineering/physics concepts to clinical care. To do this, we will do "deep-dives", going deeper than typical physiology courses and applying to real clinical cases. In this thread, we go deeper into Laplace's Law.
1/20
Last week, I had a patient with hydronephrosis. Looking at CT scans, have you noticed that the renal pelvis usually dilates out of proportion to the ureter? To me, the ureter is often tough to trace 2/2 smaller diameters. Can Laplace explain this?

2/
Just to review: Laplace's Law describes the force relationship between the surface (Tension) and interior space (Pressure). This relationship is influenced by size (i.e., Radius) and shape (cylinder vs. sphere). See the formula here:

3/
Read 20 tweets
1/15 As promised, here is a summary of my presentation from today about “Using Your Phone for Lifelong Learning”

As a note, these slides are all hyperlinked instead of referenced and can be seen in full in the previous tweet.
2/15 We started with our objectives for today. While the topic is huge, we focused on three things that have been instrumental in my education. Twitter, podcasts, and the Human Diagnosis Project.
3/15 I argued that these tools are not only useful, but also necessary! Medical knowledge is increasing too quickly for us to keep up, and using all our technology gives us an advantage at staying up to date.

Source: ncbi.nlm.nih.gov/pmc/articles/P…
Read 16 tweets
1: What causes WBC/PMN elevation (neutrophilic-predominant pleocytic) ascites? The differential is broad and extends beyond Spontaneous Bacterial Peritonitis (SBP).

(A #MedTwitter and #Tweetorials contribution). Appreciate edits by @ebtapper.
2: 26yoW w/ cirrhosis 2/2 congestive hepatopathy 2/2 hypoplastic L heart syndrome s/p Fontan presented to OSH with fevers, abdominal pain. Prev tx by PCP for ?PID w/ IM CTX, doxycycline. Dx para shows WBC 2480, PMN 74%, total protein 4.3, SAAG >1.1. What is cause of ascites here?
3. Portal Hypertension (PH) due to liver dz causes albumin- and protein-poor ascites. This is due to sinusoidal scarring causing reduced albumin and protein translocation into ascites [Serum-Ascites Albumin Gradient (SAAG) >1.1]. But this case is not due to cirrhosis...
Read 25 tweets
As @DrMarthaGulati destroys her competition today at #ACC19 , there really is no worthy debate on whether a physician should participate in #SoMe or not.

A thread on where physicians need to obtain #SoMe skills and lead...
The principles of advocacy.

Op-ed piece by Dr. LeeAnne Luft:
ncbi.nlm.nih.gov/pmc/articles/P…

Call to action by Dr. Angira Patel @sciam blogs.scientificamerican.com/observations/i…

Eye-opening @ETSshow podcast w/ @PeterHotez explorethespaceshow.com/podcasting/pet…
Novel uses of #SoMe & documentation of impact.

#Tweetorials perspective by @Doctor_V 33charts.com/tweetorial/

Article on Physician exemplars ( incl. @EricTopol @SeattleMamaDoc )
patientpop.com/blog/marketing…

#SoMe portfolios for academics jgme.org/doi/full/10.43…
Read 5 tweets
1: What causes triglyceride elevation in pleural fluid studies?

My previous understanding of this diagnostic test was recently challenged and lends credence to the fascinating diversity of pleural effusions/dz.

(A #MedTwitter and #Tweetorials contribution).
2: A middle aged woman OSH patient was transferred with LEFT pleural effusion that developed 5 days post-CABG.

Initial pleural fluid studies:
protein <0.8 LDH 2300 glucose 278 RBC 400 WBC 17.5k trigs 204 cholesterol 225 chylomicrons (-)

What type of effusion is this?
3: This is not a case of hemothorax despite the presence of (many) RBCs. A true hemothorax diagnosis requires EITHER of the following:
1.Pleural fluid hematocrit (hct) >50% peripheral hematocrit
2.RBC/100,000 (estimate for pleural fluid hct if not obtained) >50% peripheral hct
Read 19 tweets
Really impressed by the recent #tweetorials by @ADAlthousePhD & @venkmurthy on study design. I was thinking that there are lots of awesome study design methods tweetorials. I'd like to capture them in one place. Here are my favorites. Please add yours (with one line on the topic)
@venkmurthy on test vs population characteristics and other iwatch issues
Read 12 tweets
In preparation of my upcoming talk on #dermatology emergencies for the @SHMlive conference, I thought I'd put together my first #tweetorial on Stevens Johnson Syndrome (SJS). Having never done this, apologies in advance for subpar tweeting! Here we go!
1/
#medtwitter #dermtwitter
SJS and its more severe cousin, Toxic Epidermal Necrolysis (TEN), are life-threatening dermatologic toxicities, usually caused by a drug trigger. In rare cases, they can be triggered by infection (more commonly seen in the #pediatric population).

2/
#SJS usually presents with an atypical targetoid macular (flat) eruption with +nikolsky. This is in contrast to another entity on the ddx, erythema multiforme, which has classic target papular (raised) lesions. See the difference? (hands are EM, back is SJS). CC @dermnetnz!

3/
Read 11 tweets
Putting my #livertwitter #tweetorials in one place
I must have deleted my original index tweet.
(More are coming in 2019)
Read 5 tweets
Thank you so much to @PlenarySessShow @Plenary_Session for having me on episode 4 to talk about the benefits of #medtwitter! It was great to find another venue (ie not typing in < 280 characters) to discuss its role in learning, patient care, advocacy, & professional development
shout out to @ReneeDversdal (about a minute after my segment starts ~24:30) and another podcast (wink, wink, nudge, nudge @thecurbsiders)
HT also to my closest #medtwitter network, who I've gotten to collaborate with after meeting on twitter, one of the benefits discussed, with subtle nods to past and current projects!
@RJmdphilly @gretchendiemer @MargMChapman @michellebr00ks @WrayCharles @tony_breu
Read 4 tweets
1/ Thread: This morning I gave Dept of Medicine #GrandRounds @OHSUSOM @OHSUNews. In #medtwitter’s spirit of sharing & learning, here is my first #Tweetorial summarizing highlights & crediting #hcsm’s incredible contributors & source material
2/ 4 months ago EBM & cardiology expert Dr. Milton Packer published a blog post detailing how he found Twitter uninformative and emotion/opinion driven
Is this the reality of #medtwitter??
medpagetoday.com/blogs/revoluti…
3/ #SoMe is digitally based mediums that helps us
CREATE
SHARE
PARTICIPATE
60% of physicians say their most popular activity on #hcsm = Following what colleagues are sharing and discussing
Channel the “look at me” negative stereotype of #SoMe into “look at THIS” learning etc...
Read 28 tweets

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