Discover and read the best of Twitter Threads about #meded

Most recents (24)

Clinical presentation and virological assessment of 181 confirmed human #monkeypox virus cases in #Spain
✔️92%, gay men, bisexual men, or other men who have sex with men (MSM) &
✔️8%, heterosexual men or women

(A) genital & pubic region pustules
👇… Image
✔️Median age was 37 years (IQR 31–42).
✔️18% patients reported previous smallpox vaccination

(B) Three semiconfluent pustular #monkeypox lesions with a depressed centre located on the left side of the tongue dorsum.

#MedEd Image
✔️40% were #HIV-positive, 11% had a CD4 cell count less than 500 cells per μL

✔️17% were diagnosed with a concurrent sexually transmitted infection

(C) Pearly acral #monkeypox vesicles embedded in the thick stratum corneum of the palmar skin, shotty on palpation

#IDtwitter Image
Read 9 tweets
Today’s #ResearchTip is when an unethical and alarming piece of research is identified, don’t let your scramble to be part of an exciting drama mean you amplify problems or act unethically yourself.

This 🧵 is about ways to respond to unethical publications #AcademicTwitter
There is a paper, published in a qualitative journal, that is currently raising concerns and questions about how it was published. It's grim and extreme. But it's sadly not unique. There are countless examples of unethical research out there /2 #AcademicTwitter #AcademicChatter
Most of the time unethical research is stopped by good teaching and supervision (either explaining not to do it, or catching and halting it). Other places like ethics committees, participants, colleagues or reviewers can spot and prevent harm spreading /3 #AcademicTwitter
Read 51 tweets
A 40-year-old woman from Brazil, AIDS, CD4 91 cells/μL: headache, diffuse cerebral edema, coma, respiratory distress, tracheal secretion with nematode
(1), alveolar hemorrhage, periumbilical purpuric rash (2), & death

🔬brain: 3
#MedEd #IDtwitter
🔬tracheal secretion: Strongyloides stercoralis (1)

Skin biopsy: S. stercoralis larvae at the dermis and hypodermis.


#microbiology #MedStudentTwitter
Strongyloidiasis occurs worldwide, but predominates in tropical and subtropical areas.

People acquire the disease from penetration of larvae through the skin.

#MedicalStudents #MedTwitter
Read 5 tweets
Cardiac tamponade on #POCUS #echofirst
Click on 'ALT' for description
#MedEd #IMPOCUS #Nephrology
From 🔗 Two-dimensional (2D) and M-mode echocardiographic signs of p
Mitral inflow Doppler and LVOT VTI in tamponade.
'ALT' for description
#POCUS #echofirst #MedEd Respiratory variations in flow velocities by spectral Dopple
Pulsus paradoxus: during inspiration, right heart filling occurs at the expense of the left, so that its transmural pressure transiently improves & then reverts during expiration (Ventricular interdependence). Seen as 👆on #POCUS
Read 5 tweets
It really upsets me when doctors roll their eyes at patients who come into the office prepared. I bring with me:
- a binder with my records sorted by body system
- a "short copy" of the most relevant records
- recent labs
- a list of current meds, drs, and their contact info 1/7
I also bring a copy of an agenda that includes
- symptomology of current issue
- ongoing interventions
- questions I have regarding potential treatments.

I need all this because I don't have anyone to serve as a patient advocate. I have brain fog. 2/7
These records keep me on track for when a doctor asks a question about a surgery I had a decade ago, or an issue I saw twenty different practitioners for since childhood bc I moved frequently. I need these records. 3/7
Read 7 tweets
Today’s #ResearchTip is envy is sadly very common in academia and often linked to competition (which many are taught as a positive thing). Remember your candle won’t burn brighter just because you blew out someone else’s flame. #AcademicChatter #AcademicTwitter #HigherEd #MedEd
It can be difficult when everyone around you seems to be sharing successes, making progress, or not experiencing blocks and barriers. It can make you feel angry, sad, anxious or inferior. And impact negatively on working relationships or your interactions online. #AcademicChatter
It may be tempting to blame other people for their progress, success or happiness rather than recognise and make space for your own disappointment, worries, or rejection. #AcademicChatter #AcademicTwitter #HigherEd #MedEd #PhdChat #gradschool #PhDHelp
Read 13 tweets
Clinical features and novel presentations of human #monkeypox of 197 patients in a #London centre during the 2022 #outbreak

Median age: 38 years
All 197: men, &
196 identified as gay, bisexual, or other men who have sex with men
#IDtwitter #MedTwitter
Concomitant infection:
- 35.9%: HIV
- 31.5%: a concomitant sexually transmitted infection.

All presented with mucocutaneous lesions, most commonly on the genitals (n=111 participants, 56.3%) or in the perianal area (n=82, 41.6%).

#Doctor #MedStudentTwitter
86.3% participants reported systemic illness:
✔️ fever 61.9%),
✔️ lymphadenopathy (57.9%), and
✔️ myalgia (31.5%).

#monkeypox #resident
Read 14 tweets
"Your diagnosis is elevated uric acid. You need to stop eating 🍅🥗🥦🥪🥩🫘, basically everything"

Beware of these!!

Elevated uric acid doesn't always 🟰 gout

#MedEd #MedTwitter #gout #Uricacid
Gout is a form of arthritis due to deposition of excess uric acid in joints and it usually has (not always) high serum uric acid levels.
If one has gout, then avoid:

🍺 Alcohol
🥩 Red meat
🧃 packed juices, carbonated drinks (high fructose corn syp)
Read 4 tweets
👩‍🦳 in her 70s: on the L 🦶, initially appeared pruritic papules that evolved to fluid-filled blisters with tense and denuded bullae (Fig1).

Over the ensuing 6 weeks an expanding annular plaque with peripheral scale (Fig2).
#dermatology #mycology
🔬(KOH): hyphae
🧫: Trichophyton rubrum


The patient responded well to terbinafine cream and dilute acetic acid soaks.

#microbiology #IDtwitter
Bullous tinea, seen in adults and children, and most often affecting the feet, presents with an erythematous scaly rash with serous fluid-filled bullae, as opposed to the pus-filled blisters of bullous impetigo.

#MedTwitter #Doctor #MedStudentTwitter #MedEd
Read 4 tweets
Today’s #ResearchTip is your #PhD is the only time you’ll “go it alone” as a researcher (and many still work in teams for their doctoral studies). Learning to work with colleagues and communities is a great skill to acquire during your doctorate. #AcademicTwitter #AcademicChatter
#PhD candidates can be misled to believe working with others is “cheating” in some way. It isn’t. It’s a great way to share ideas, expand horizons and also get or give help in areas you or others need support with. #PhDChat #PhDHelp #gradschool #HigherEd #MedEd #AcademicChatter
Future research projects, even for independent researchers, doesn’t happen in a vacuum. We need to coordinate with others to understand, progress and make an impact with our studies. Identifying and maintaining your networks is a key skill. #PhDChat #PhDHelp #gradschool #HigherEd
Read 8 tweets
34-YO👨‍🦰congenital, idiopathic intestinal pseudo-obstruction, total parenteral nutrition & infusion of lipid emulsions: fever & cough (paroxysmal coughing with his port infusion)

CXR: interstitial infiltrates & areas of faint alveolar opacities
Portacath blood
Smear: globose, oval, budding #yeast with a small collarette, suggesting Malassezia spp.
Olive oil–supplemented🧫: Malassezia sympodialis (identified by DNA sequencing)


The portacath was removed, & the patient was given liposomal amphotericin B, for 4 weeks.

His symptoms were gone by week 2, and the interstitial infiltrates were nearly resolved by week 4.
#mycology #IDtwitter #MedTwitter
Read 7 tweets
Today's #ResearchTip is if you want to share your work and promote yourself - go where the people you want to reach are!
That might be here, ORCID, ResearchGate, on Instagram, TikTok, LinkedIn, your uni's website, or a personal profile
#AcademicTwitter #AcademicChatter #HigherEd
There's often a recommendation to get a personal website. That can be useful as your career builds. However I'd recommend an ORCID profile first and foremost. If you get a website you need to send people to it, which can be a job in itself! Have a plan for that #AcademicChatter
You can use different platforms for different purposes. ORCID plus Scholar or ResearchGate for your publications. Twitter, Facebook and LinkedIn for networking and help seeking. TikTok or Insta for public engagement and cat photos. There are lots of choices #AcademicChatter
Read 7 tweets
18-YO👨‍🦱: painful tender, fluctuant mass mass over the R anterior sin, chronic right knee pain, weight loss.

⬆️inflammatory markers (ESR, CRP)

XR & MR: ?
#Orthopedics #radiology #MedEd
X-ray: areas of lucency & sclerosis in the proximal tibial metadiaphysis
MR: consistent with an chronic osteomyelitis & intraosseous abscess with myositis involving the adjacent musculature

A presumptive diagnosis of BRODIE ABSCESS

#IDtwitter #MedTwitter
Debridement with sequestrectomy
3 deep bone: Aggregatibacter aphrophilus
🔬: bone remodeling, fibrosis, & mixed lymphoplasmacytic & histiocytic infiltrates

#microbiology #Doctor
Read 9 tweets
ICU POCUS snippets: Much has been said about how useful lung POCUS is for procedural guidance. First of all, it accurately reveals large effusions when the radiology report characterizes them as “small”. This is from a recent case of a pt intubated w community-acquired pneumonia
and what proved to be bilateral parapneumonic effusions:
Secondly, while the dogma (which, btw, I don’t recommend completely ignoring!) in thoracentesis is to insert the needle at the “triangle of safety”, bordered by the anterior border of the latissimus dorsi, the lateral border of the pectoralis major, the horizontal line at the...
Read 12 tweets
51-YO🧔‍♂️alcoholic homeless living with dog in southern France: fever, confusión, a maculopapular rash on the trunk (A), hypotension, disorientation, an eschar on his right shoulder (B), & several tiny black spots
Careful examination: these spots were actually #ticks (a total of 22) attached on the skin; they were removed

During 25 h, he was examined by diferente doctors. Dermatologic examination was woefully incomplete, as often occurs when unhygienic, homeless, &/or drunken patients
All ticks were identified as #Rhipicephalus sanguineus, the brown dog tick, including 1 female (A) and nymphs (B).

#IDtwitter #dermatolgy
Read 5 tweets
It's here! After many years of working on this 2nd edition, it's amazing to finally see and hold it!
I learned so much revising and updating this book, a 🧵
#MedEd #MedTwitter #neurotwitter #NeuroTwitterNetwork @NMatch2023 @caseyalbin @DxRxEdu
One of the most fun things to write was the preface, reflecting on how much has changed and evolved in #neurology in just a few years since the 1st edition. More on why I love neurology here:
For example the antiseizure medication table has expanded from 1 page to two...
Read 10 tweets
A 28-YO👨‍🦰traveling through Africa & Asia: a pruritic, erythematous rash on his back, trunk, buttocks, genitals, & lower limbs; dry cough & wheeze

X-ray: bilateral reticulonodular infiltrates
#IDtwitter #MedTwitter #dermatology ImageImageImage

The “creeping” skin lesions are diagnostic of CLM

The pustular rash across the patient’s buttocks & back is likely secondary to CLM folliculitis—a rarer, but well-described skin manifestation of CLM

#Doctor #MedEd ImageImage
The patient’s cough and chest radiograph findings are characteristic of Loeffler syndrome, a recognized but rare complication of CLM.

CLM is caused by the infective stage larvae of animal hookworms from the family Ancylostomidae.

#MedStudentTwitter #resident Image
Read 7 tweets
1/16 Yet another fantastic AM report @LosAngelesVA!

Facilitator: @BrandonCSmithMD
Presenter: Danny Xu, MD (@uclaimchiefs PGY-2)

CC: lower back pain (LBP)

#MedTwitter #MedEd #FOAMed
2/ Brandon asked the group three questions:
1⃣ What is your approach to the pain?
2⃣ How does that inform your next steps for history and physical?
3⃣ How does that inform your next diagnostic steps?
3/ Group answers:
1⃣ We discussed an approach that is nicely captured by this slide
2⃣ The group wanted to know the tempo, progression and radiation
3⃣ Imaging at this juncture seemed premature but the thought was entertained
Read 16 tweets
1/ “When you have time, can we look over one of my notes?”

Do you have an approach to teaching when learners ask for feedback on documentation? Check out the following thread for some high-yield tips!

#MedEd #MedEdTwagTeam #TweetorialTuesday #MedTwitter Image
2/ As a reminder, we are still in our series on inpatient teaching. I typically will teach about notes after rounds. Image
3/ First… in your opinion, how valuable is it for learners to receive feedback from notes?
#MedEd #MedTwitter #MedStudentTwitter
Read 14 tweets
1/4: 🚨 “Do you think it’s ok to give this patient zofran? What about their QTc?” 🚨

#Tweetorial on QT prolonging drugs and torsades de pointes (TdP) 🧵
#MedEd #MedTwitter
2/4: How much does 8mg of ondansetron ⬆️ Qtc by?

What about 32 mg?

One study suggests low doses of QTc prolonging meds are unlikely to cause TdP in your avg patient, but would be careful if QTc > 500 or patient/drug is higher risk.
3/4: Not all drugs are created equal!

Common antiarrhythmics are more likely to cause TdP. Other drugs have a risk, but most are only documented as case reports (PMID: 32929996)
Read 4 tweets
42-YO African American man, AIDS, CD4 57 cells/ mm3: 18-mth of progressively multiple papules coalescing into large exophytic nodules & plaques on face, scalp, & neck (A & B); & several lesions in in the groin, penis, & RUE
#dermatology #idtwitter ImageImage

Molluscum contagiosum is a benign skin tumor caused by molluscum contagiosum virus.

Lesions >1 cm diameter are known as giant molluscum

#Virology #MedEd #MedTwitter
Well-circumscribed intraepidermal lobules containing molluscum bodies (arrow)
These structures, which are composed of viral particles & cellular debris, are pathognomonic for this condition
Molluscum bodies enlarge and rise to the surface as cells age

#Doctor #dermatologia Image
Read 8 tweets
1/3- 🙋‍♂️12 KEY TRIALS I teach on #ICU Rounds each week residents & fellows must know!

BACK by request for July!

Do you agree?
Any you would add?

1. ARDSNET @NEJM-PMID 10793162

2. LEUVEN Glucose 1 @NEJM-PMID 11794168

3. SAFE Trial @NEJM-PMID 15163774
#FOAMcc #medtwitter #MedEd
2/3🙋‍♂️12 Key ICU TRIALS I teach each week continued…

4. TRICC Trial @NEJM PMID: 9971864

5. SOAP Vasopressor trial @NEJM PMID: 20200382


7. Rivers EGDT @NEJM PMID 11794169

8. VAAST Trial @NEJM PMID 18305265

9. SMART Fluids @NEJM PMID 29485925
🙋‍♂️ 3/3 12 KEY ICU TRIALS I teach each week continued…


11. Schweickert Early Mobility @Lancet PMID19446324

12. ABC Trial @TheLancet PMID 18191684

What others would you add?

#FOAMcc #FOAMed #SCCMSoMe #medtwitter #MedEd #MedStudentTwitter
Read 3 tweets
Sunday Morning ☕️ Break

☐ Top Retirement Plans
☐ $1.3 Billion Dollar Baby
☐ World's Best Kept Secret
☐ Financial Death Spiral
☐ Cayman Islands Cruise
☐ Mental Health Crisis
☐ Mi Casa Es Su Casa
☐ $5.1 Million Bailout
☐ Misinformation Everywhere

🧵 #MedTwitter #MedEd
Read 11 tweets
Redundancy is a threat to increasingly more people working in universities. Here's a 🧵with ideas on how to look after yourself if you're at risk, based on my experiences. Please share widely /1 #AcademicTwitter #AcademicChatter #HigherEd #MedEd
Worried about redundancy? Before you do anything else make sure you've a strong network of friends and family around you. They may be near or far, on or offline, but you need as many people on your side as possible /2 #AcademicTwitter #AcademicChatter #HigherEd #MedEd
When I say get 'friends' on your side, I would ensure the majority are *not* your work friends and colleagues. Why? Because redundancy is brutal and people you considered your work friends and allies will often let you down. #AcademicTwitter #AcademicChatter #HigherEd #MedEd
Read 65 tweets

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