Discover and read the best of Twitter Threads about #medstudents

Most recents (24)

By popular demand - For any 3rd year #medstudents starting on #InternalMed, here are some tips to be successful on this rotation:

1. Show up early. Pt lists change frequently & management is complex - the more time u have to get to know cases, the more successful u will be. 🧵
2. Read about diagnoses, medications, therapy, and more. The more time you spend educating yourself, the better prepared you are to answer questions on rounds! Resources such as @OnlineMedEd, @UpToDate, @DynaMed_EBSCO, and @VisualDx are a great place to start.
3. Reading about cases outside of rounds will help to solidify information and learn to think more critically about each new case you see. You will think back to prior diagnosed cases each time you encounter a new patient! It is important to build this information foundation.
Read 7 tweets
For any 3rd year #medstudents starting on #surgery, here are some tips I found helpful as to how to be successful on this rotation:

1. Arrive early - on time is 15 min before start. Offer to print the patient list and write new lab values before sign out from the night 🧵 Image
2. Stalk the OR board the night before. Know who’s going and for what reason. If there’s any surgeries you’re unfamiliar with, look up the anatomy the night before.
3. Get to the OR before your patient. Get to know the scrub techs and nurses, give them your gloves and gown if you’re scrubbing in, joke with them and make friends - your experience will be SO much better!
Read 8 tweets
Pterygopalatine fossa🧵- inspired by ?s from med students in neuroanatomy lab & a resident w/ case of perineural tumor spread on same day! #meded #FOAMrad #medtwitter #medstudents #radiology #neurorad #HNrad #radres #neurology #ENT #temporalbone #neurosurgery #neuroanatomy
The PTERYGOPALATINE FOSSA (PPF) is a space deep in the face/skull base, bordered anteriorly by the maxilla (max sinus), posteriorly by the pterygoid base of the sphenoid, and medially by the perpendicular plate of the palatine bone. 2/22
It’s best to think of the PPF as a crossroads/intersection. Think about the roads that lead to and from it, and the cast of characters that pass through.

Some like to simplify/visualize the PPF as a cube or inverted pyramid.

Read 22 tweets
#MedStudents - Need help with your perspective. Quick questions!

1. If you were to match at your home medical school for residency in your specialty, and they offered starting you in residency 2 months Early (May 1st instead of July), how likely would you be to take them up?
2. If you were offered to start residency 9 months Early (Oct M4 yr) at your home medical school, but meant you were LOCKED their program, how likely would you be to take them up?
(ie less tuition, no interview trail, no NRMP, early med school grad = end residency sooner)
3a. [ANSWER IF SAID UNLIKELY TO ? #2] What is the biggest factor you would be unlikely to participate in an early-match / early residency start at your home institution?
Read 5 tweets
As an ethicist who teaches #medstudents about the ethics of organ allocation I'm thrilled that organ transplantation is in the news. But many are troubled by the latest case. Is it right to refuse a heart to the unvaxxed? Who decides? Read on for, I hope, some clarity... A🧵...
First, some background.
One perspective:…
Read 26 tweets
#MedStudents, #Residents, #Fellows, and #Research Trainees - I recently had both a resident and fellow ask me how I got involved in research and published when I was a #trainee. I thought I would share my tips and advice in this thread. #MedTwitter #ACGME #MedStudentTwitter
1. Ask yourself👉what you want from this? To pursue research as career? To boost application for #residency #fellowship #employment? To get a recommendation letter? Regardless, aim for #publication (most value). Conference talks are cool, but publications stay on CV forever!
2. Basic science research=⬆️time+lab training vs clinical research. Study designs: RCTs, prospective, retrospective, case reports, review papers. Publishing case reports+review papers are most feasible endeavors during training! Best way to boost #publication numbers.
Read 22 tweets
Neuroanatomy TOTD #15🧵
The inner ear #tweetorial--it packs a large functional punch for its small size-strap in!
#meded #FOAMed #FOAMrad #medtwitter #medstudents #radiology #neurorad #HNrad #radres #neurology #ENT #temporalbone #neurosurgery #neuroanatomy #neuroanatomyTOTD
To evaluate the t-bone, best to compartmentalize--external/middle/inner ear (IE). See previous #tweetorial of the ME. The IE is difficult as most structures are obliquely oriented (at different obliquities!)-and can be hard to see on standard views. 2/24
IE communicates with ME via oval&round windows (which allow for transmission&dissipation of sonic vibrations). IE houses sensory organs for hearing/balance/sensing motion. The cochlear&vestibular nerves (CNVIII) transmit signals to the brain via the int auditory canal (IAC). 3/24
Read 25 tweets
Neuroanatomy TOTD #14🧵
Got some requests to do one of the trickiest areas of human anatomy, the #temporalbone. So many named structures! #meded #FOAMed #FOAMrad #medtwitter #medstudents #radiology #neurorad #radres #neurosurgery #neuroanatomy #ENT #otolaryngology

1/21 Image
Whether learning t-bone anatomy as a medical student or evaluating a CT of the t-bone as a radres, it’s best to compartmentalize into external, middle, and inner ear. This thread🧵is on the middle ear: Inner ear to follow, some day:)

2/21 Image
The external ear extends from the external meatus to the TM. The TM should be thin and *almost* imperceptible on CT. Thickened and retracted TM suggests prior pathology (usually otitis media) and scarring.

3/21 Image
Read 22 tweets
Neuroanatomy TOTD #12

The green structure is the amygdala (amygdaloid body) and the yellow structure is the stria terminalis (ST).


#meded #FOAMed #FOAMrad #medtwitter #medstudents #radiology #neurorad #radres #neurology #neurosurgery #neuroanatomy #neuroanatomyTOTD
Time for a deep dive into limbic networks. Bear with me—this is a fun subject. I got carried away preparing slides—it’s hard to know when to stop!

The amygdala is an almond-shaped collection of gray nuclei/subnuclei deep to the uncus and ant to hippocampus in the med temporal lobe. Involved in multiple functions: memory modulation, emotional learning and responses, +important connections w/ the olfactory bulb/cortex.

Read 18 tweets
Neuroanatomy TOTD #10🧵 
1/5 Small gray matter structure at the junction of the thalamus and midbrain is the subthalamic nucleus (STN).

#meded #FOAMed #FOAMrad #medtwitter #medstudents #radiology #neurorad #radres #neurology #neurosurgery #neuroanatomy #neuroanatomyTOTD
2/5...The STN is functionally a node within the basal ganglia (BG) INDIRECT LOOP. STN contains excitatory glutaminergic neurons➞output to the GABA neurons of GPi, which in turn have inhibitory effect on thalamic outputs to the motor cortex.
3/5...Loss of nigrostriatal input in Parkinsons Dz➞increased inhibitory output from GPi➞decreased thalamic stimulation of the motor cortex (through both direct and indirect loop circuits). Makes sense that DBS treatments were initially directed at disrupting activity in GPi.
Read 5 tweets
Neuroanatomy TOTD #9🧵
1/6 The trigeminal n. courses anteriorly➡️prepontine cistern➡️into Meckel’s cave (green), which lies at the medial floor of middle cranial fossa at the petrous apex.
#meded #FOAMed #FOAMrad #neurorad #neurology #neurosurgery #neuroanatomy #neuroanatomyTOTD Image
2/6...Meckel’s cave (MC) is open to the subarachnoid space at its posterior margin (and is therefore filled with CSF). The trigeminal (Gasserion) ganglion lives in MC. Superiomedial to MC (and sharing a dural border), is the cavernous sinus. #radres #neurorad Image
3/6...Coursing anteriorly, the V1 and V2 branches of CNV exit MC to travel within the lateral wall of the cavernous sinus. V3 courses inferiorly to exit the middle cranial fossa through foramen ovale, without involving the cavernous sinus. Image
Read 6 tweets
Sharing our invited review: Transjugular intrahepatic portosystemic shunt (TIPS) in #cirrhosis/World #Journal of #Gastroenterology. @SRajesh_IR helms 24-page colossus discussing exhaustively recent studies #livertwitter #MedTwitter #irad #GITwitter
Full: Image
Topics we discuss include - variceal bleeding (incl ectopic), #ascites & #hydrothorax (incl chylous), #complications, new techniques, #stent size dilemma & extensive point of care algorithmic approaches in portal hypertension complications, eg: esophageal #variceal bleeding 👇 Image
#New techniques such as combined approach for difficult anatomy situation in TIPS in cirrhosis 👇 Image
Read 7 tweets
1/#Morningreport @SinaiBmoreIMRes
featured a young patient presenting with abdominal pain X 2 weeks with a serum K=2.8.
There was also increased urinary frequency
some weakness and fatigue during the past 2 weeks
#DDX #MedTwitter #medstudents #FOAMed
2/The DDX for Hypokalemia requires consideration of a 3 pronged approach: 1)Decreased intake 2)Renal and GI losses and 3) IC shifts. Image
3/For the workup: Spot urine potassium and 24 hour urinary Potassium suggested urinary K wasting.
[UK] high (>40 mEq/L) =renal K loss
TTKG of 9 was concerning for renal potassium wasting
In hypokalemia (K⁺ <3.5 mEq/L), the TTKG > 7 suggests renal K wasting. Image
Read 9 tweets
#livertwitter #GITwitter #MedTwitter #tweetorial
#Cirrhosis, right lobe atrophied, relative hypertrophy of left lobe
📌Splenic/superior mesenteric vein blood flow changes👉distortion of liver structure, re-routing hepatotropic substances to left, less to right➡️ Rt atrophy
1/ Image
❓But in #BuddChiari #Syndrome, caudate lobe enlarged
📌"#laminar flow’ theory"👉 larger redistribution of nutritients,hormones,hepatotropic factors to left hemi-liver at caudate level, most portal branches supplying caudate lobe from left portal vein #MedStudentTwitter
2/ Image
#Fatigue primary biliary cholangitis (#PBC)
📌cholestasis, #endotoxemia, systemic #Inflammation👉dysautonomia, central/peripheral neurovascular dysfunction, sympathetic overactivity, impaired baroreflexes, low peripheral #muscle perfusion, lactic acid mishandling, fatigue
Read 9 tweets
Urinary History Taking for #MedStudents #TrishasTweetorial

Struggle to take an effective, comprehensive #UH in a 5 min #OSCE?

#sdocs @MedicsAcademy @MedTweetorials #TrishasTopTips 👇👇
When did you last take a urinary history?
Before we start #FristThingsFirst I’m a Realist

Urinary History is not ≠ to Urogynae History #PelvicFloorDisorders

For ☝️ use:
#Urinary dysfunction
#Sexual dysfunction
#Bowel dysfunction
#Vaginal dysfunction
Read 19 tweets
43yr chronic #alcohol user on Liv.52 #Herbal supplement for 1yr. Believes Liv52='hepatoprotective'. Consumes along with to cancel alcohol-toxicity. Diabetes uncontrolled on #Ayurveda. Comes with #jaundice, severe #headache, eyes 'bulged' 2 days, nasal discharge #livertwitter Image
At admission, #seizures, uncontrolled, put on #ventilator. Deep jaundice, comatose. Investigations=acute on #chronic liver failure #aclf
#MRI Brain Part 1👇
Extensive hemorrhagic infarcts, almost all of anterior and mid #brain.
#medicine #MedTwitter #radiology Image
MRI Brain Part 2👇
Both sides cortical venous thrombosis and anterior third of superior saggitsl sinus thrombus.
#imaging #stroke #NeuroTwitter #neurology #NeuroTwitterNetwork Image
Read 5 tweets
Would you like some #greentea #extract #Herbal #supplements drink for #weightloss?
Good, you can enjoy your #weightlosstransformation 6-ft-under. Here is what #greentea extract does👉liver biopsy #marked regions = what is left of liver
#livertwitter #pathology #LiverPath ImageImage
1. Check/declare your supplements.
2. Be wary of #nutrition and #weight management #quacks
3. Want #loseweightfast? - sweat it out, dont sweat your liver out.
4. #STAY away - multilevel marketing #FRAUDS
More 👉
#MedTwitter #MedStudents #media #healthy
Never forget the #sexist, #outrageous, #PANIC inducing #advertisement that #pseudoscience #Ayurveda and #Homeopathy uses as #fishing #bait on unassuming persons
NO '#faster way to lose weight' - its a #myth
#health #education #MedEd #publichealth #shortstories #girls ImageImage
Read 3 tweets
10 year old #boy. Loss of weight, very high #appetite, ⬆️thirst, urination - 6 months. LFT - AST 1200, ALT 2300, ALP, Bil, INR - normal. Wilsons, autoimmune -ve. IgG - 2xULN. CTscan - massive hepatomegaley. #Liver #biopsy 👇 Rare! ❓ #livertwitter #MedTwitter Image
HbA1c is 15.2🔥Uncontrolled #diabetes with hepatic #glycogenosis, diastase treatment, glycogen disappears! [Mauriac Syndrome] 6 months intensive #nutrition & #insulin, Repeat biopsy - #normal liver!
Scary presentation in a child, but simple #treatment
#medicine #pathology
Read 3 tweets
1/ Tips for #JuniorDocs interested in become involved in research

Thanks @drjacksonblythe for asking!

A thread…
2/Why should #JuniorDocs consider research?

🔬Improve your critical analysis skills

🧬Contribute to evidence based-medicine

👋🏽Collaborate with amazing researchers & clinicians

👩🏻‍🎓Establish new career opportunities

📝(And yes, it looks good on your CV!) Image
3/How do #JuniorDocs start out in research?

🤩Pick an area you are ACTUALLY interested in

🗣Ask your registrars, consultants, nursing & allied health colleagues about any research opportunities

🧪Contact your nearest university & ask about collaborating projects to help with Image
Read 7 tweets
The @AmerMedicalAssn's stance on Taking care of our students: Preparing for the 2021 residency application cycle.

So far.. lots of #medstudents attending this sesh
Most programs are considering #virtualinterviews

#MedStudentTwitter #MedED #classof2021
Lots of important stakeholders represented in the Coalition for Physician Accountability.

Next month: watch out for the report on pathways for graduating medical students (#class2020) and their journey to residency.

"We anticipate stakeholders will commit to policies that prioritize these guiding principles yet recognize the necessity for innovation and flexibility in this new #COVID19 environment"
Read 22 tweets
1/ Primary Care Case of the Week 5

Each week I’d like to share a case for #MedStudents to continue developing their clinical reasoning, even though not on clinical placement at present.

All cases are fictitious, but inspired by those seen in #PrimaryCare

#MedEd #MedTwitter
2/ 5yo F presents to the general practice clinic with a fever & a rash. Mum has been giving her paracetamol & ibuprofen, but it hasn’t seemed to really help.

🤦🏻‍♀️Oh no! Not a fever & a rash!

🤷🏼What are your differentials?

🤷🏽‍♂️What additional info would you like on history & exam? Image
@am_baker @lucierobson @AlisonBoast would you like to play along?
Read 8 tweets
Does dizziness make you feel dizzy?
It's complicated, so here is a #Tweetorial on Dizziness!

#MedEd #MedStudentTwitter #MedStudents #neurology
cc: @Tracey1milligan @MadSattinJ @CPSolvers @rabihmgeha @DxRxEdu @AANMember @ContinuumAAN 1/
Try to determine if the dizziness falls into one of these categories:
1 Vertigo (sense of movement)= neurologic or inner ear
2 Light-headed=CV related
3 Dysequilibrium=gait issue
4 other=anxiety

This classic paper is worth the read
But the history for type of dizziness is not sensitive/specific, as the work of @DNewmanToker has shown… Note title: “Why “What do you mean by ‘dizzy’?” Should Not Be the First Question You Ask”

Still it's a good place to start...
Read 22 tweets
Happening now: In the middle of the #COVID19 pandemic #FutureDoctors can’t take #USMLE exams for licensure because of failures at @NBMENow, @TheUSMLE, @TheFSMB, and @PrometricGlobal, putting current and future patients at risk. 1/12
Did you know: after years of school, $100k’s of debt, months of 12hr/day dedicated study, students are reporting @PrometricGlobal, @NBMENow, @TheUSMLE are cancelling exams for medical students with < 24 hours notice. 2/12
After @PrometricGlobal cancelled exams, they also turned off phone lines, locking out students with disabilities or other ADA protected accommodations from the only mechanism to reschedule the most important exam of their lives. 3/12
Read 12 tweets
1/ Primary Care Case of the Week 4

Each week I’d like to share a case for #MedStudents to continue developing their clinical reasoning, even though not on clinical placement at present.

All cases are factitious, but inspired by those seen in #PrimaryCare

#MedEd #MedTwitter
2/ A 50yo male presents to the clinic with an itchy red rash

🤦🏻‍♀️Not another itchy red rash?! (We see a lot of itchy red rashes in #PrimaryCare!)

💁🏼What’s in your list of differentials?

💁🏽‍♂️What additional information would you like from this patients history & physical exam? Image
3/ Cutaneous Lava Migrans

🏝Parasitic skin infection

🏝Caused by hookworm larvae usually infest cats & dogs

🏝Humans infected with larvae when walking barefoot on sand/soil contaminated with animal faeces Image
Read 5 tweets

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