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

Top Biomedical Science

@imedverse

What is the Diagnosis?

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

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

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Top Biomedical Science

@imedverse

@medics_AbuSaif

Beautiful anatomy graphics from @medics_AbuSaif

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

Read 24 tweets

Oren Gottfried, MD

@OGdukeneurosurg

Saline is a powerful surgical instrument. #neurosurgery #bleed #meded #clinicalpearl

Credit to this neurosurgeon

Craniotomy for Evacuation of acute subdural hematoma causing compression on brain. See primer on SDH from Netter.

Read 3 tweets

EKGDX

@ekgdx

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

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

Read 4 tweets

Top Biomedical Science

@imedverse

ABCDE steps to Chest X-RAY Interpretation

#pulmonary #pulmtwitter #pulmonology #respiratory #internalmedicine #TipsForNewDocs #MedEd #MedTwitter #medicine #medical #medicare #health #healthcare #FOAMed #ClinicalPearl #clinicaltips #MedStudents #xray #Radiology

Chest X-RAY Interpretation 2

#pulmonary #pulmtwitter #pulmonology #respiratory #internalmedicine #TipsForNewDocs #MedEd #MedTwitter #medicine #medical #medicare #health #healthcare #FOAMed #ClinicalPearl #clinicaltips #MedStudents #xray #Radiology

Chest X-RAY Interpretation 3

#pulmonary #pulmtwitter #pulmonology #respiratory #internalmedicine #TipsForNewDocs #MedEd #MedTwitter #medicine #medical #medicare #health #healthcare #FOAMed #ClinicalPearl #clinicaltips #MedStudents #xray #Radiology

Read 8 tweets

Top Biomedical Science

@imedverse

@ManualOMedicine

Causes of acute pancreatitis

@ManualOMedicine #TipsForNewDocs #MedEd #MedTwitter #medicine #medical #medicare #health #healthcare #FOAMed #ClinicalPearl #clinicaltips #MedStudents #GITwitter #Gastroenterology

Causes of Acute Pacreatitis

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

Acute Pancreatitis – Causes, Pathology, Symptoms and Signs, Investigations, Management and Complications

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

Read 4 tweets

Top Biomedical Science

@imedverse

⚡️Nephrotic vs nephritic syndrome

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

⚡️Nephrotic vs nephritic syndrome

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

⚡️Nephrotic vs nephritic syndrome

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

Read 5 tweets

Top Biomedical Science

@imedverse

@PTFlashcards

Rheumatoid arthritis vs. Osteoarthritis /pt1

@PTFlashcards @imedverse #TipsForNewDocs #MedEd #MedTwitter #medicine #medical #medicare #health #healthcare #FOAMed #ClinicalPearl #clinicaltips #MedStudents

@PTFlashcards

Rheumatoid arthritis vs. Osteoarthritis /pt2

@PTFlashcards @imedverse #TipsForNewDocs #MedEd #MedTwitter #medicine #medical #medicare #health #healthcare #FOAMed #ClinicalPearl #clinicaltips #MedStudents

Osteoarthritis vs. Rheumatoid Arthritis

via stephbeggs part 1/2

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

Read 4 tweets

Top Biomedical Science

@imedverse

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

Salter-Harris Classification

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

@radiologistpage

Salter-Harris Classification
@radiologistpage /1

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

Read 5 tweets

Top Biomedical Science

@imedverse

@medictests

Pitting Edema Grading

@medictests @imedverse #TipsForNewDocs #MedEd #MedTwitter #medicine #medical #medicare #health #healthcare #FOAMed #ClinicalPearl #clinicaltips #MedStudents #edema

@drmiketodorovic

Causes of Oedema

@drmiketodorovic #imedverse #TipsForNewDocs #MedEd #MedTwitter #medicine #medical #medicare #health #healthcare #FOAMed #ClinicalPearl #clinicaltips #MedStudents

@thecurbsiders

Lower extremity edema differential diagnoses

@thecurbsiders @BrownJHM @imedverse #TipsForNewDocs #MedEd #MedTwitter #medicine #medical #medicare #health #healthcare #FOAMed #ClinicalPearl #clinicaltips #MedStudents

Read 6 tweets

Oren Gottfried, MD

@OGdukeneurosurg

50 yo female with progressive eye redness and loss of visual acuity. She has a h/o hypertension. Thoughts? #MedEd
#MedTwitter #health #healthcare #FOAMed #ClinicalPearl #clinicaltips #neuroscience #neurotwitter
#sciencetwitter #brain #medstudenttwitter #medical

Neuro intact other than vision.

What is reason for redness, specifically?

Read 4 tweets

Steven Chen 陳持威, MD, MPH, MHPEd

@DrStevenTChen

I learned an interesting #clinicalpearl today!

Did you know that in Wilson Disease, despite high ALT/AST/bilirubin, Alkaline Phosphatase (AP) stays normal or low?

It made me ask "why," & so, I present the answers I found in #tweetorial form.

A rare non-derm, #medtwitter 🧵
1/

Let's start by establishing that Wilson Disease is a multisystem process wherein copper deposits in various tissues (liver, brain, eyes) because of improper transport.

A mutation in ATP7B causes this, and the depositional process leads to disease manifestations.
2/

Given the organs Cu2+ deposits in, you see neurologic effects, Kayser Fleischer rings in the eyes, and of course, liver disease.

While here👇, we see the always memorized, rarely seen, Kayser Fleischer rings, let's focus on the liver...

PC: nejm.org/doi/full/10.10…
3/

Read 11 tweets

Dr. Om Lakhani, MD, DNB (ENDO)

@omlakhani

#Medtwitter #ClinicalPearl

This thread will tell you how Quackery works...

Step 1: Quacks understand the market needs. If patients find oncology treatment painful and expensive, they will 'create' a product for cancer. Quacks understand entrepreneurship

Step 2: Once the "area of need" is identified, quack delivers a product that is relatively cost-effective (and largely ineffective). It could be a mixture of "herbs", "natural product", some fancy-sounding "diet"

Read 19 tweets

Dr. Om Lakhani, MD, DNB (ENDO)

@omlakhani

#Medtwitter #EndoTwitter #ClinicalPearl

Karyotype must be offered to all women presenting with Premature ovarian insufficiency (POI)

There is no age cut-off per se for ordering a karyotype in women with POI. In a study, more than 30% of women with abnormal karyotype were more than 30 years of age!

Additionally, when you order a karyotype in women, it is also imperative to order FISH to look for Cryptic Y chromosome material

Read 5 tweets

Dr. Om Lakhani, MD, DNB (ENDO)

@omlakhani

#MedTwitter #ClinicalPearl #Endotwitter

Is your patient having persistently high TSH , despite increasing the dose of your thyroid medications ? The patient on the other hand is asymptomatic and the T4/Free T4 values are always normal. Contd..

High TSH despite adequate LT4 replacement is a common clinical issue that we deal with in Endocrinology and it is an area of several #ClinicalPearl threads

However today we focus on one such issue on possible reason for the problem. The reason is what is called a Heterophile antibody

Read 11 tweets

Dr. Om Lakhani, MD, DNB (ENDO)

@omlakhani

#ClinicalPearl #MedTwitter

A patient comes to you with a thyroid function test suggestive of Thyrotoxicosis, but the patient has absolutely no clinical features of the same. What do you do ?

In such a scenario, you need to look for Biotin interference with endocrine lab assay

50% of endocrine tests have been developed using biotin in their separation step

A high dose of biotin (defined as biotin intake >5 mg /day) is often a component of dermatological treatment. It is also a treatment for multiple sclerosis.

Read 7 tweets

Dr. Om Lakhani, MD, DNB (ENDO)

@omlakhani

#ClinicalPearl #MedTwitter

GLP-1 and GIP are both incretin hormones. Incretins are the X factor in the pathogenesis of type 2 diabetes and are a key component of the 'Ominous octet' - the 8 factors that cause type 2 diabetes. Contd..

But GLP-1 and GIP have subtle differences

GLP-1 inhibits insulin and also inhibits glucagon secretion

Read 8 tweets

Dr. Om Lakhani, MD, DNB (ENDO)

@omlakhani

Symptoms of primary & central adrenal insufficiency are similar. Anorexia, fatigue, weight loss, etc are common to both. However, patients with central adrenal insufficiency DO NOT have POSTURAL DIZZINESS & SALT CRAVING which are seen with primary adrenal insufficiency

This is because patients with central adrenal insufficiency do not have mineralocorticoid deficiency unlike those with primary adrenal insufficiency. Salt craving and orthostatic symptoms are generally due to mineralocorticoid defects. #endotwitter #ClinicalPearl

In Primary adrenal insufficiency, the loss of the mineralocorticoid function proceeds the loss of glucocorticoid function. Mineralocorticoid axis can be tested by measuring the plasma renin level. The elevation of plasma renin occurs before the fall of cortisol. #ClinicalPearl

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