Discover and read the best of Twitter Threads about #medstudenttwitter
Most recents (24)
ICU stories (a brief one): 60 yo male w lung cancer / CAD / HTN / HLD / status post chemotherapy a month ago presented to the ED w SOB/cough/weakness after failing outpatient tx w azithromycin. CT chest: no PE but positive for bilateral consolidations:
Patient came to the ICU intubated, sedated, on pressors & antibiotics for PNA. Next step: POCUS. PLAX looked "weird", so Doppler and "zoomed" views were recorded:
PSAX & subcostal views:
A 44-YO♂️, stayed in a rural cottage of France 2 weeks previously: cramping upper abdominal pain with watery diarrhea.
He had passed what he thought were worms in his feces
Eosinophilia
1/6
doi.org/10.1093/cid/ci…
#GITwitter #IDtwitter #microbiology
He had passed what he thought were worms in his feces
Eosinophilia
1/6
doi.org/10.1093/cid/ci…
#GITwitter #IDtwitter #microbiology
The specimens: identified as the larvae of the drone fly, Eristalis tenax
These larvae are 2.5–3 cm in length; the posterior tube gives them the name of “rat-tailed maggots”
INTESTINAL MYASIS CAUSED BY ERISTALIS TENAX LARVA
2/6
doi.org/10.1093/cid/ci…
#parasites #GIPath #Doctor
These larvae are 2.5–3 cm in length; the posterior tube gives them the name of “rat-tailed maggots”
INTESTINAL MYASIS CAUSED BY ERISTALIS TENAX LARVA
2/6
doi.org/10.1093/cid/ci…
#parasites #GIPath #Doctor
Myiasis caused by E. tenax:
✔️rare but have been
✔️reported from various countries including Europe
✔️most often intestinal myiasis, but cases of infestation of the nasal cavity, urinary tract, and vagina have been described.
3/6
#Doctor #MedStudentTwitter
✔️rare but have been
✔️reported from various countries including Europe
✔️most often intestinal myiasis, but cases of infestation of the nasal cavity, urinary tract, and vagina have been described.
3/6
#Doctor #MedStudentTwitter
#ACC23 #WCCardio is jam packed w/ >300 sessions over 3 days w/ >80 live-streaming sessions around the world 🔥
Here’s how you can make the most of it👇🏻 (🧵)
@ACCinTouch @DougDrachmanMD @EdwardFryMD @Pooh_Velagapudi @agtruesdell @KBerlacher @taraloujones @SarasVallabhMD
1/5…
Here’s how you can make the most of it👇🏻 (🧵)
@ACCinTouch @DougDrachmanMD @EdwardFryMD @Pooh_Velagapudi @agtruesdell @KBerlacher @taraloujones @SarasVallabhMD
1/5…
1. Are you attending #ACC23 #WCCardio in-person?
Great!
‘Coz you can install the App & get everything you need to navigate the meeting 👇🏻
iPhone: apps.apple.com/us/app/acc-23-…
Android: play.google.com/store/apps/det…
#CardioTwitter #MedTwitter #ACCFIT #ACCEarlyCareer #CardioEd
2/5…
Great!
‘Coz you can install the App & get everything you need to navigate the meeting 👇🏻
iPhone: apps.apple.com/us/app/acc-23-…
Android: play.google.com/store/apps/det…
#CardioTwitter #MedTwitter #ACCFIT #ACCEarlyCareer #CardioEd
2/5…
2. Not very App savvy? No problem!
You can use ACC Online Program Planner to build an itinerary that meets all your needs 👇🏻
abstractsonline.com/pp8/#!/10674
#CardioTwitter #MedTwitter #ACCFIT #ACCEarlyCareer #CardioEd #MedStudentTwitter
3/5…
You can use ACC Online Program Planner to build an itinerary that meets all your needs 👇🏻
abstractsonline.com/pp8/#!/10674
#CardioTwitter #MedTwitter #ACCFIT #ACCEarlyCareer #CardioEd #MedStudentTwitter
3/5…
ICU stories (from the trenches): 70 yo pt w hx of A-fib/CAD/ICM w EF 25%/VT ablation s/p BiV ICD/CKD/HTN/HLD/peripheral vasc dz/COPD etc presented to outside 🏥 w SOB/weakness/falls. Labs: wbc 15k/creat 3.5 (baseline 2.0)/INR: 8.5/AST/ALT/Tbil: 180/250/3.0, lactate 3.5
RUQ US was obtained to work-up elevated LFTs:
Diagnosed w bilateral PNA/AKI/liver dysfunction. Treated for sepsis w ivf boluses, broad-spectrum antibiotics, steroids, bicarb. Continue to get worse; due to ⬆️O2 needs, transferred to our 🏥. I saw her the next am: in resp distress while on BiPAP 15/10-100%, abg 7.26/50/70/19.
Nice paper on cardiorenal syndrome (CJASN; 2023. doi: doi.org/10.2215/CJN.00…)
Proposed pathophysiological pathways leading to the cardiorenal syndrome and its complications
Proposed pathophysiological pathways leading to the cardiorenal syndrome and its complications
"The inciting event is usually an acute decompensation of heart failure. This may lead to either arterial underfilling or venous congestion as mediators that promote neurohormonal activity, inflammation, & endothelial dysfunction. In combination, these pathways lead to ⬇️ in GFR.
Complications include Na avidity and fluid retention, reduced kidney clearance, and endocrine function, all of which further perpetuate the pathophysiology".
A 26-YO♂️ no #sexual contacts other than with his male partner: 6-day of fever, malaise, a swollen parotid gland, & ulcerative lesion on the ipsilateral lower lip.
Mild lymphopenia
⬆️GGT & CRP
1/6
doi.org/10.1016/S0140-…
#IDtwitter #dermatology #EarNoseThroat
Mild lymphopenia
⬆️GGT & CRP
1/6
doi.org/10.1016/S0140-…
#IDtwitter #dermatology #EarNoseThroat
PCRs on the throat & ulcer swabs:➕for human #monkeypox (hMPX)
Genomic sequencing: clade IIb variant clustering within the current international mpox virus outbreak
PAROTIDITIS CAUSED BY hMPX virus
2/6
#sexually #maxillofacial #microbiology
Genomic sequencing: clade IIb variant clustering within the current international mpox virus outbreak
PAROTIDITIS CAUSED BY hMPX virus
2/6
#sexually #maxillofacial #microbiology
7 days after initial presentation, his clinical condition had improved together with a decrease in the parotid swelling and the size of the ulcer.
3/6
#MedTwitter #Doctor #MedStudentTwitter
3/6
#MedTwitter #Doctor #MedStudentTwitter
A 58-YO♂️, DM, fever & L lower quadrant abdominal pain 2 months prior: acute R-sided back pain, & 3/6 diastolic murmur at R upper sternal border.
CT: a R renal infarction & splenic embolism
MR: multiple infarctions
1/7
doi.org/10.1016/j.idcr…
#Cardiology #medicine #cardiologia
CT: a R renal infarction & splenic embolism
MR: multiple infarctions
1/7
doi.org/10.1016/j.idcr…
#Cardiology #medicine #cardiologia
Transesophageal echocardiography: a vegetation and severe aortic regurgitation.
Blood 🧫: Cardiobacterium hominis
CARDIOBACTERIUM HOMINIS ENDOCARDITIS ASSOCIATED WITH CEREBRAL, RENAL, AND SPLENIC INFARCTIONS
2/7
#IDtwitter #microbiology
Blood 🧫: Cardiobacterium hominis
CARDIOBACTERIUM HOMINIS ENDOCARDITIS ASSOCIATED WITH CEREBRAL, RENAL, AND SPLENIC INFARCTIONS
2/7
#IDtwitter #microbiology
The patient received antibiotic therapy and surgical aortic valve replacement, and he was doing well without major complications.
3/7
#infecciosas #MedTwitter #Doctor
3/7
#infecciosas #MedTwitter #Doctor
A 71-YO therapy for multiple mieloma, voriconazole for Aspergillus fumigatus sinusitis, prophylaxis with TMP-SMX: febrile neutropenia, nodular lesion on abdominal wall
CT: pulmonary nodule unchanged in last a month
🔬biopsy of pulmonary nodule?
1/8
#Pathologists #haematology
CT: pulmonary nodule unchanged in last a month
🔬biopsy of pulmonary nodule?
1/8
#Pathologists #haematology
🔬: Histiocytic process with granular basophilic cytoplasm and Michaelis-Gutmann bodies (arrows), positive for calcium with von Kossa special stain (arrowhead); findings pathognomonic for malakoplakia.
PULMONARY MALAKOPLAQUIA
2/8
doi.org/10.1093/cid/ci…
#pathTwitter
PULMONARY MALAKOPLAQUIA
2/8
doi.org/10.1093/cid/ci…
#pathTwitter
🧫of the pulmonary nodule:➖
🧫biopsy of the abdominal wall lesion: Rhodococcus equi resistant to TMP-SMX, but susceptible to rifampicin, vancomycin, azithromycin, ciprofloxacin, & imipenem.
RHODOCOCCUS EQUI SUBCUTANEOUS ABSCESS
3/8
doi.org/10.1093/cid/ci…
#microbiology
🧫biopsy of the abdominal wall lesion: Rhodococcus equi resistant to TMP-SMX, but susceptible to rifampicin, vancomycin, azithromycin, ciprofloxacin, & imipenem.
RHODOCOCCUS EQUI SUBCUTANEOUS ABSCESS
3/8
doi.org/10.1093/cid/ci…
#microbiology
A 57-YO Mexican♀️, works on a farm has several pets, including dogs, at home: epigastric fullness, and a 15-pound weight loss.
CT: complex cystic left liver mass.
1/5
doi.org/10.1093/cid/ci…
#gastroenterology #radiology #medicine
CT: complex cystic left liver mass.
1/5
doi.org/10.1093/cid/ci…
#gastroenterology #radiology #medicine
Resection: Cyst wall (red➡️), daughter cysts (*) normal liver tissue (yellow⬅️)
🔬acellular laminated wall (*), inner germinal layer (black⬅️), & protoscoleces surrounded by a broad capsule (green⬅️). Refractile hooklets (blue⬅️) & calcareous bodies (red⬅️)
2/5
#GIPath #IDtwitter
🔬acellular laminated wall (*), inner germinal layer (black⬅️), & protoscoleces surrounded by a broad capsule (green⬅️). Refractile hooklets (blue⬅️) & calcareous bodies (red⬅️)
2/5
#GIPath #IDtwitter
ECHINOCOCCAL CYST
The patient underwent total excision of the cyst followed by albendazole therapy for 4 weeks.
3/5
doi.org/10.1093/cid/ci…
#microbiology #GITwitter #MedStudentTwitter
The patient underwent total excision of the cyst followed by albendazole therapy for 4 weeks.
3/5
doi.org/10.1093/cid/ci…
#microbiology #GITwitter #MedStudentTwitter
A 17-YO♀️, unprotected #sexual intercourse with multiple male partners: a 1-month history of pruritic genital lesions, multiple smooth, grayish-white papules & plaques were noted on the vulva & upper inner thighs.
1/5
DOI: 10.1056/NEJMicm2207538
#gynecology #womenshealth
1/5
DOI: 10.1056/NEJMicm2207538
#gynecology #womenshealth
A Treponema pallidum particle agglutination assay:➕
Rapid plasma reagin titer: ➕1:16.
CONDYLOMA LATA OF SECONDARY SYPHILIS
2/5
#microbiology #gynecologist #primarycare
Rapid plasma reagin titer: ➕1:16.
CONDYLOMA LATA OF SECONDARY SYPHILIS
2/5
#microbiology #gynecologist #primarycare
✔️Testing for other sexually transmitted infections, including HIV infection: ➖
✔️Counseling on the importance of condom use
✔️IM penicillin G benzathine
At the 1-month follow-up visit, the lesions had resolved, and the RPR was 1:8.
3/5
#dermtwitter #IDtwitter #MedTwitter
✔️Counseling on the importance of condom use
✔️IM penicillin G benzathine
At the 1-month follow-up visit, the lesions had resolved, and the RPR was 1:8.
3/5
#dermtwitter #IDtwitter #MedTwitter
A 29-YO♂️, 6 months before, HIV + & non–drug-resistant pulmonary tuberculosis, antiretroviral & 4-drug antituberculous therapy initiated but soon reduced to rifampin & isoniazid only: abdominal pain on the L side
CT: ?
1/5
DOI: 10.1056/NEJMicm2206174
#radiologist #GITwitter
CT: ?
1/5
DOI: 10.1056/NEJMicm2206174
#radiologist #GITwitter
CT: an enlarged spleen with numerous hypodense lesions (A).
CD4 cell count: 119/mm3
VIH viral load: 1778 copies/mm3
A splenectomy was performed to evaluate for cancer:
numerous necrotic nodules with purulent discharge (B).
2/5
#microbiology #gastroenterology #IDtwitter
CD4 cell count: 119/mm3
VIH viral load: 1778 copies/mm3
A splenectomy was performed to evaluate for cancer:
numerous necrotic nodules with purulent discharge (B).
2/5
#microbiology #gastroenterology #IDtwitter
🔬granulomatous inflammation with caseous necrosis (C) and acid-fast bacilli (D, arrowheads).
A tissue🧫: ➖
PCR: ➕for Mycobacterium tuberculosis
SPLENIC TUBERCULOSIS
3/5
#bacteriology #MedTwitter #GIPath
A tissue🧫: ➖
PCR: ➕for Mycobacterium tuberculosis
SPLENIC TUBERCULOSIS
3/5
#bacteriology #MedTwitter #GIPath
A 17-YO: a 3-week of dizziness, headache, & weakness of the R leg
MR: ring-enhancing lesions in the frontal lobe & basal ganglia on the L side (A; T1-W) as well as surrounding edema & midline shift (B; T2-W)
1/6
DOI: 10.1056/NEJMicm2202196
#neurology #radiology #IDTwitter
MR: ring-enhancing lesions in the frontal lobe & basal ganglia on the L side (A; T1-W) as well as surrounding edema & midline shift (B; T2-W)
1/6
DOI: 10.1056/NEJMicm2202196
#neurology #radiology #IDTwitter
IgG ab for Echinococcus multilocularis & E. granulosus: ➖
Surgical excision🔬: necrotic tissue, granulomatous inflammation, echinococcal laminated membrane (C, arrow) & an intact cyst (D, arrow)
RT-PCR: ➕for E. multilocularis
2/6
#parasitology #Pathologists #pathology
Surgical excision🔬: necrotic tissue, granulomatous inflammation, echinococcal laminated membrane (C, arrow) & an intact cyst (D, arrow)
RT-PCR: ➕for E. multilocularis
2/6
#parasitology #Pathologists #pathology
CT imaging of the chest and abdomen did not show any other sites of disease.
CEREBRAL ALVEOLAR ECHINOCOCCOSIS
3/6
DOI: 10.1056/NEJMicm2202196
#microbiology #MedTwitter #Doctor
CEREBRAL ALVEOLAR ECHINOCOCCOSIS
3/6
DOI: 10.1056/NEJMicm2202196
#microbiology #MedTwitter #Doctor
A 14-yo ♂️ lived on a farm: a 1-month history of episodic headaches, vomiting, & papilledema
MR: a multiloculated cyst of the brain (A) with a hypointense rim and small projections in T2 phase (B, arrow)
1/5
DOI: 10.1056/NEJMicm2208104
#neurology #radiology #pediatric
MR: a multiloculated cyst of the brain (A) with a hypointense rim and small projections in T2 phase (B, arrow)
1/5
DOI: 10.1056/NEJMicm2208104
#neurology #radiology #pediatric
Findings suggestive of CYSTIC ECHINOCOCCOSIS.
CT of the body: no other sites of disease.
A craniotomy was performed, during which saline irrigation was used to separate the cyst wall from the brain to avoid rupture.
2/5
DOI: 10.1056/NEJMicm2208104
#IDtwitter #parasitology
CT of the body: no other sites of disease.
A craniotomy was performed, during which saline irrigation was used to separate the cyst wall from the brain to avoid rupture.
2/5
DOI: 10.1056/NEJMicm2208104
#IDtwitter #parasitology
🔬: an echinococcal laminated membrane lined by a germinal layer with daughter cysts (Panel D, arrows) and protoscolices (inset, arrows) with hooklets (arrowhead).
PRIMARY CEREBRAL CYSTIC ECHINOCOCCOSIS FROM ECHINOCOCCUS GRANULOSUS
3/5
#microbiology #Pathologists #pathology
PRIMARY CEREBRAL CYSTIC ECHINOCOCCOSIS FROM ECHINOCOCCUS GRANULOSUS
3/5
#microbiology #Pathologists #pathology
A thread on mechanics, logistics and reasons behind positive end expiratory pressure (PEEP) significance while handling patients on mechanical or non-invasive ventilation 🧵
#MedTwitter #EDTweeter #PulmTwitter @PulmPEEPs
#MedTwitter #EDTweeter #PulmTwitter @PulmPEEPs
PEEP is the air pressure that stays “WITHIN” the lungs after a person finishes exhaling. Now, this PEEP pressure is always greater than atmospheric pressure. It essentially prevents the alveoli’s to collapse and maintains the airways open.
CPAP is a non-invasive mode of ventilation which works by the same principal of PEEP, I.e. to provide end expiratory positive pressure
EPAP means expiratory positive airway pressure which works with the same logic & dynamics of PEEP, but is used for patients receiving BPAP
EPAP means expiratory positive airway pressure which works with the same logic & dynamics of PEEP, but is used for patients receiving BPAP
A 50-YO♂️of North India, visited bat caves & a bird sanctuary in Thailand: multiple plaques & nodules on his face, neck, arms & trunk with hoarseness, fever, weight loss for months
Laryngoscopy: nodules over the tonsils & posterior pharyngeal wall
1/4
#medicine #dermatology
Laryngoscopy: nodules over the tonsils & posterior pharyngeal wall
1/4
#medicine #dermatology
Skin & laryngeal 🔬: histiocytes with intracellular & extracellular PAS+ yeast cells
Skin biopsy🧫: tuberculate macroconidia confirmed as H. capsulatum var. capsulatum
Ab against Histoplasma by ID:➕
DISSEMINATED HISTOPLASMOSIS
2/4
doi.org/10.3109/136937…
#mycology #IDtwitter
Skin biopsy🧫: tuberculate macroconidia confirmed as H. capsulatum var. capsulatum
Ab against Histoplasma by ID:➕
DISSEMINATED HISTOPLASMOSIS
2/4
doi.org/10.3109/136937…
#mycology #IDtwitter
Disseminated histoplasmosis involving skin & larynx in an apparently immunocompetent individual
The infection appeared to be imported from Thailand.
The patient responded very well to intravenous amphotericin B followed by itraconazole.
3/4
#microbiology #MedTwitter #Doctor
The infection appeared to be imported from Thailand.
The patient responded very well to intravenous amphotericin B followed by itraconazole.
3/4
#microbiology #MedTwitter #Doctor
ICU stories (a common one): It's Saturday, Jan 28, 2023. You just came on service at 7:00 am & at the same time, they were rolling in a case from the OR (Friday night case = never good...). 65 yo pt w DM2/diastolic HF/CAD/A fib/HTN/PVD. Had 10 ds' hx of abd pain; CT A/P showed
evidence of ischemic bowel. Pt came to the ICU after an exp-laparotomy w partial small bowel resection. The gut was left in discontinuity & the abdomen was left open. Pt still sedated & paralyzed, on norepi 0.18. A sleep-deprived anesth CRNA is telling you that the surgeon plans
to bring the pt back to OR for 2nd look on Monday. You feel so lucky; pt already has lines from the OR, you just have to keep him sedated for 2 days. Piece of cake! You move on to the other pts but the RN interrupts your dream rounds in 5 min. What about maintenance fluids, doc?
A 46-YO ♂️: oropharyngeal lesions, cervical lymphadenopathy, intermittent fever, hepatosplenomegaly, and deteriorating general health.
Needle aspiration from submandibular lymph node: intra- and extracellular yeasts
1/4
DOI:
doi.org/10.4269/ajtmh.…
#dermpath #mycology
Needle aspiration from submandibular lymph node: intra- and extracellular yeasts
1/4
DOI:
doi.org/10.4269/ajtmh.…
#dermpath #mycology
The histopathology of oral lesion showed features of HISTOPLASMOSIS confirmed later from culture of Histoplasma capsulatum on culture
2/4
#IDtwitter #microbiology #MedTwitter
2/4
#IDtwitter #microbiology #MedTwitter
In immunocompetent hosts, when chronic disseminated histoplasmosis occurs from pulmonary infection, oral ulcers, nodules, and vegetative plaques are common and dissemination to liver, spleen, bone marrow, and other organs is frequent.
3/4
#Doctor #MedStudentTwitter #resident
3/4
#Doctor #MedStudentTwitter #resident
A 37-YO, farmer in India, #HIV+ immunecompromised ♂️, treatment for suspected pulmonary tuberculosis: papulonodular lesions of 3-month duration over the face, neck, trunk, limbs, palms & soles, & oropharynx; fever & generalized lymphadenopathy
🔬: ?
1/7
#IDTwitter #microbiology
🔬: ?
1/7
#IDTwitter #microbiology
🔬: Blastoconidias within the macrophages.
🧫: Histoplama capsulatum: characteristic colony, conversion to yeast form, characteristic🔬appearance.
PROGRESSIVE DISSEMINATED HISTOPLASMOSIS
2/7
doi: 10.4269/ajtmh.17-0432
#dermpath #mycology #internalmedicine
🧫: Histoplama capsulatum: characteristic colony, conversion to yeast form, characteristic🔬appearance.
PROGRESSIVE DISSEMINATED HISTOPLASMOSIS
2/7
doi: 10.4269/ajtmh.17-0432
#dermpath #mycology #internalmedicine
Diagnosis is usually suspected on visualization of characteristic intracellular yeast (blastoconidias), the pathogenic or tisular form, with a clear rim and garnulomatous cellular infiltrate in tissue specimen or lymph node aspirate
3/7
#MedTwitter #Doctor
3/7
#MedTwitter #Doctor
1/3-💥 12 KEY TRIALS I teach on #ICU Rounds each week trainees must know!
BACK by request!
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
#SCCMSoMe #FOAMed
BACK by request!
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
#SCCMSoMe #FOAMed
2/3 12 Key ICU TRIALS I teach each week
4. TRICC Trial @NEJM PMID: 9971864
5. SOAP Vasopressor trial @NEJM PMID: 20200382
6. NICE-SUGAR @NEJM PMID 19318384
7. Rivers EGDT @NEJM PMID 11794169
8. VAAST Trial @NEJM PMID 18305265
9. SMART Fluids @NEJM PMID 29485925
#FOAMcc #ICU
4. TRICC Trial @NEJM PMID: 9971864
5. SOAP Vasopressor trial @NEJM PMID: 20200382
6. NICE-SUGAR @NEJM PMID 19318384
7. Rivers EGDT @NEJM PMID 11794169
8. VAAST Trial @NEJM PMID 18305265
9. SMART Fluids @NEJM PMID 29485925
#FOAMcc #ICU
💥 3/3 12 KEY ICU TRIALS I teach each week continued…
10. APROCCHSS @NEJM PMID 29490185
11. Schweickert Early Mobility @Lancet PMID19446324
12. ABC Trial @TheLancet PMID 18191684
What others would you add?
#FOAMcc #FOAMed #SCCMSoMe #MedTwitter #MedEd #MedStudentTwitter
10. APROCCHSS @NEJM PMID 29490185
11. Schweickert Early Mobility @Lancet PMID19446324
12. ABC Trial @TheLancet PMID 18191684
What others would you add?
#FOAMcc #FOAMed #SCCMSoMe #MedTwitter #MedEd #MedStudentTwitter
ICU stories (a brief one): One hour before the end of the am shift, u walk around in the ICU to make sure thinks look OK before u type your sign-out note. You spot the resp therapist & the nurse bagging the pt in Rm 306. From the hallway, u see the monitor: HR 160, RR/45, Sat 70%
This is a 30 yo pt w hx of a catastrophic brain bleed, s/p trach & PEG, admitted 2 wks ago w MDR Klebsiella UTI. Doing well, on trach mask 28%, until the episode of acute/unexpected desaturation
When u examine the pt, s/he is in extremis (accessory muscle use-tachycardic-tachypneic-diaphoretic). BP: 105/55. You grab the stethoscope that the resp therapist wears around his neck & you hear breath sounds in both sides (pt is skinny...)
A 31-YO ♂️, sex with men, HIV treatment, HCV: in 2022, fever, cervical lymph nodes & erythemato-squamous papules, with umbilications & ulcerations, vesicles & pustules, & honey-colored crusts on the face, trunk & limbs including his palms & soles
1/7
#IDtwitter #primarycare
1/7
#IDtwitter #primarycare
PCR: ➕for MPXVirus.
#HIV viral load of < 40 copies/mL and a CD4 + count of 167 cells/mm3
#MPOX (MONKEYPOX)
2/7
#healthcare #internalmedicine #microbiology
doi.org/10.1016/j.idcr…
#HIV viral load of < 40 copies/mL and a CD4 + count of 167 cells/mm3
#MPOX (MONKEYPOX)
2/7
#healthcare #internalmedicine #microbiology
doi.org/10.1016/j.idcr…
Supportive care of Mpox was provided, namely,
✔️beta-lactams due to bacterial superinfection of the lesions,
✔️in addition to analgesia, which was initially administered with NSAIDs and then escalated to opioids.
3/7
#MedTwitter #MedStudentTwitter #dermtwitter
✔️beta-lactams due to bacterial superinfection of the lesions,
✔️in addition to analgesia, which was initially administered with NSAIDs and then escalated to opioids.
3/7
#MedTwitter #MedStudentTwitter #dermtwitter
A 32-YO ♂️ sex worker, sex with men unprotected, HIV under treatment: 20 lesions scattered throughout the body of umbilicated, erythematous, violaceous papules with central ulcerations & pustules, fevers, cervical & axillary lymph nodes
1/5
#IDtwitter #primarycare #healthcare
1/5
#IDtwitter #primarycare #healthcare
HIV viral load of 1577 copies/mL and a CD4 + count of 932 cells/mm3
PCR: ➕ for Mpox virus
MPOX (MONKEYPOX)
2/5
#internalmedicine #microbiology doi.org/10.1016/j.idcr…
PCR: ➕ for Mpox virus
MPOX (MONKEYPOX)
2/5
#internalmedicine #microbiology doi.org/10.1016/j.idcr…
Mpox had been a neglected disease until May, 2022, and since then, there has been a notorious increase in the number of human monkeypox cases in non-endemic areas
3/5
#MedTwitter #MedStudentTwitter #dermtwitter
3/5
#MedTwitter #MedStudentTwitter #dermtwitter
An 86-YO ♂️, injury on his L leg 47 years prior, several debridements, skin grafts, & vein stripping procedures: chronic bilateral leg progressive ulcers.
Superficial🧫: multiple organisms including E. coli & coagulase➖Staphylococcus.
1/6
#internalmedicine #IDtwitter
Superficial🧫: multiple organisms including E. coli & coagulase➖Staphylococcus.
1/6
#internalmedicine #IDtwitter
Skin biopsy🔬: bilateral invasive squamous cell carcinomas.
BILATERAL INVASIVE SQUAMOUS CELL CARCINOMAS (MARJOLIN ULCERS)
2/6
#dermatology #dermpath
doi.org/10.1093/cid/ci…
BILATERAL INVASIVE SQUAMOUS CELL CARCINOMAS (MARJOLIN ULCERS)
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#dermatology #dermpath
doi.org/10.1093/cid/ci…
The mean time period between development of a wound to malignancy is 30–35 years.
The most common malignancies seen in Marjolin ulcers are squamous cell carcinomas, but basal cell carcinomas and melanomas have been reported.
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#Doctor #healthcare #MedStudentTwitter
The most common malignancies seen in Marjolin ulcers are squamous cell carcinomas, but basal cell carcinomas and melanomas have been reported.
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#Doctor #healthcare #MedStudentTwitter
#MedTwitter #MedStudentTwitter it's rank list season!
Location, location, location matters.
What framework should MS4 use to understand training program location?
(MS2-3 might want to know this for next year before interviews start!)
Read on... 🏙️🏠
Location, location, location matters.
What framework should MS4 use to understand training program location?
(MS2-3 might want to know this for next year before interviews start!)
Read on... 🏙️🏠
With 10-50 hours of functional & wakeful time each week, your geography plays a big role. Here's how to consider people, activities, specific program training sites, lived experience, and financial cost when evaluating a program's location... 🏙️🏠
First, think about the people, activities, & locations that matter most to you. Who are your loved ones? What types of people do you want to surround yourself with outside of work? Culture, background, family, & values all play a role in location choice. 💕🏙️
