Discover and read the best of Twitter Threads about #medicine

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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
A 19-YO👩‍🦰, taken care of an 11-YO👦with bronchitis: cough, fever, dyspnea & pneumonia (XR)
Levofloxacin➡️hypoxia resolved, but:
- Orolabial blisters & rash, day 8
- Conjunctivitis, day 9
- Hemorrhagic denuded labial lesions, day 17
1/7…#IDtwitter #MedEd
🔬skin lesion: interface dermatitis, consistent with erythema multiforme/Stevens-Johnson syndrome–type histological changes
ELISA for M. pneumoniae IgM, initially➖, &➕at day 10

Extrapulmonary manifestations of M. pneumoniae infection:
✔️in 10% of patients
✔️mucocutaneous eruptions, central nervous system disease, carditis, hemolytic anemia, and Raynaud disease associated with cold agglutinins, renal disease, or arthritis.


#MedTwitter #Doctor
Read 7 tweets
A 25-yo woman, cirrhosis due to autoimmune hepatitis, not pneumococcal vaccination: rapidly progressive sepsis with purpura fulminans.

16 h after admission, violaceous non-blanching ecchymoses from proximal thighs to the calves, & flaccid bullae.

#dermatology #MedEd Image
36 hours after admission, the skin was dusky & violaceous with sharply demarcated borders, bullae filled with red to black-colored fluid

Blood🧫: pan-susceptible Streptococcus pneumoniae.

#IDtwitter #MedTwitter Image
She had progressive hypoxia & shock despite maximal ventilator & vasopressor support, & the patient passed away within 48 h of admission.

Autopsy: a cirrhotic liver, diffuse alveolar damage, & five liters of serous fluid in the abdominal compartment.

#Doctor #resident
Read 9 tweets
Tips on writing a NIH R01 on #AI. In last 6 weeks our group landed 4 @NIH / @theNCI R & U grants on #AI in #imaging & #medicine. I got a number of enquiries about grant writing tips. I share some thoughts below. Also free offer - Happy to review & provide f/b on your S aims page
1. Specific Aims page - Most important page of your proposal. Articulate the clinical unmet need, followed by your unique solution, your preliminary data, brief description of team, your approach/specific aims and most critically your success criteria. Sample SA page below.
2. Significance/Background - Most important section in your narrative. Focus on unmet clinical need. What is the status quo & why is it not sufficient? (cost, tech etc). What is needed ? How will this impact unmet need? Who will be impacted? How many? Who will use tech?
Read 12 tweets
Niño de 4 años: fiebre de dos días, enrojecimiento y edema leve en el pabellón auricular derecho, con posterior aparición de vesículas y ampollas.

🖊️Agámez SN, Cáceres J.…
@ContinuumAEP @aepediatria
#pediatria #Pediatrics #dermatologia
✔️inicio súbito
✔️múltiples vesículas sobre base inflamatoria
✔️a veces ampollas
✔️generalmente en un sitio único
✔️evolucionan a lesiones exudativas y ulcerocostrosas (figuras)
✔️sin secuelas.

#MedEd #IDtwitter #MedTwitter
Puede acompañarse de fiebre, malestar, afectación del estado general, adenopatía cervical y dolor

✔️La gingivoestomatitis y la faringitis, las manifestaciones más frecuente de la primoinfección, y
✔️el herpes labial, más propio de reactivación

#Doctor #MedStudentTwitter
Read 4 tweets
When we start to improve the education in the medical field on EDS and awareness in the general population it will have to naturally lead to more funding and research because people will know what it is, more will be accurately diagnosed & more people want to study it 🧵
Start at the bottom, start educating undergrads in biology and human A&P classes, start educating healthcare professionals and it will improve SO many aspects of the disease from diagnosis to research and treatments.
How do we fix education? Require students to learn it. Put connective tissue disease / EDS questions on professional exams for nurses, physical therapists, physicians, etc. If people *have* to know it, schools and programs will be forced to teach it.
Read 4 tweets
What do you think is the biggest disconnect between the clinic and research when it comes to hEDS?
Here are my thoughts:
- many things are “known EDS things” that EDS providers see. But this data often isn’t published or easily accessible by researchers so there is no follow up on why and how those things happen
- genetics often stops with clinical geneticists and doesn’t reach a lab that can follow up with biology

- a lack of continuity of care so patients see multiple specialists that don’t always know the whole picture outside of their speciality, which is then missing from research
Read 6 tweets
A 58-YO, toothache: swelling in the neck, sore throat, chills, chest pain; oral cavity indurated & woody, neck adenopathy; erythema spreading from his neck down over his anterior chest wall (A & B)

#MedEd #IDtwitter #dermatology #MedTwitter
DOI: 10.1056/NEJMicm065036
LUDWING´S ANGINA is an infectious process involving the submental, sublingual, and submandibular spaces.

It can rapidly progress to hemodynamic instability and airway obstruction; in rare cases, it spreads into the mediastinum.

#Doctor #MedStudentTwitter #resident
Compromise of the airway can progress rapidly, with lethal consequences; therefore, immediate consideration should be given to surgical débridement of the infected areas and antimicrobial therapy.

#medicine #MedicalStudents #microbiology #surgery
Read 4 tweets
A 49-YO man “looking through branches in a tree.”: decreased vision in his L eye.

Fundus: linear and arcuate disturbances in the retina (A).

What´s in the vitreous?!! (B)

DOI: 10.1056/NEJMicm075735
#parasitology #OJO #Ophthalmology Image
A fly larva was initially observed in the macula and after 4 days of treatment with thiabendazole, a segmented fly larva in the vitreous (B).


#oftalmologia #parasites #eye Image
The patient elected to undergo vitrectomy.
Eight weeks after the vitrectomy, the lesions in the retina were attenuated and the visual acuity had improved to 20/40.

#MedEd #IDtwitter #MedTwitter
Read 4 tweets
Thread Alert 💥💥
Know the difference between a HEART ATTACK & a CARDIAC ARREST 💥 ( Have patience to read this for your own welfare & share if you care) (1/n)
#MedTwitter #cardiotwitter #Emergency #medicine #Covid_19 Image
Difference between a heart attack & cardiac arrest .💥(2/n) Image
Signs & symptoms of Heart Attack :
Chest pain
Breathing difficulty
Pain radiating to the jaw,neck,back ,shoulders
Pins & needles in arms
Vomitting or vomitting sensation
Excessive sweating
( One needn't hv all symptoms)(3/n)
Read 13 tweets
1/Hello all,Good morning! Happy independence week🇮🇳🎉🎊
Got a beautiful chest teaching case 👇🏻Xray ▶️CT ▶️HPE

🛑27 year old female came with h/o chest discomfort, breathing difficulty, cough x 1 week

Lets breakdown it✍️📝 🔥
#radres #chestrad #Pulmonology #MedTwitter #FOAMrad Image
2/ Frontal CXR shows homogenous opacity in R.mid & lower zone in paravertebral region
❇️It has well defined superior,inferior&lateral borders, medial border is merged with mediastinum(incomplete border sign)
♉️Opacity has Broad base contact with mediastinum s/o mediastinal origin Image
❇️Lung lesion will be covered by lung margins all side(not always) & form an acute angle with meds
♉️Normal silhouette of right heart border is seen (neg silhouette sign) s/o lesion not in ant med
🉑Hilar vessels are seen coursing through the opacity (Hilum overlay sign +ve) ImageImage
Read 7 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
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
👩‍🦳 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
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
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
1/15 I interview antiaging expert Aubrey de Grey. He has been interviewed by Joe Rogan and 60 minutes. He corrects mistaken views on aging and talks big new developments. significant human life extension by 2035 #aging #antiaging #Future…
2/15 Next Level Funding has been reached for Antiaging has been reached. Over $12B+ invested. Billions from Jeff Bezos and Saudi Hevolution fund. Progress is not money limited.…
3/15 Antiaging expert Aubrey de Grey talks new trends and big new antiaging developments…
Read 15 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
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
So I watched this webinar & have a few thoughts.

Incoming mega🧵 on #Medicine & #ModernAg

Buckle up.
At the dawn of the 20th century life expectancy for Americans hovered around 45 years of age.

In other parts of the globe, people lived to the ripe old age of 30.
At the same time ~ 45% of the American population farmed.

According to 1950 census data 1 out of 2 Americans lived on a farm in 1900.…
Read 25 tweets
1) Somebody just asked me about the management of scorpion bite --> something I have never dealt with before.

Apparently, they are divided by species and by presentation --> autonomic storm/neuromuscular toxicity or DIC!

India --> Mesobuthus spp --> autonomic storm!
2) How did I learn all this within 5 minutes?


The single most important resource for internists everywhere.

I love textbooks, but this is the digital age.
3) Textbooks will help you with the deep diving but for POC medicine where time is of the essence and you need high fidelity, organized information --> you will need UpToDate.

Unpopular opinion and @stethospeaks may skewer may for this --> but this is what I stand by!
Read 4 tweets

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