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1/What other complications of EtOH do you think of, #medtwitter?
Would you organize this differently?
Teaser courtesy of @ArsalanMedEd:
+ EtOH level without any EtOH exposure (oral intake or otherwise)???
2/Check out this @CPSolvers case with @hdx and @HannahRAbrams for a fascinating case that discussed the "mast cell complications"
#FOAMed
clinicalproblemsolving.com/2019/02/21/epi…
3/#medtwitter friends, thank you so much for your incredible input. Here is version 2 of this schema.
4/ h/t to @OAmidiMD and others for the correct answers to the teaser:
Auto-brewery Syndrome!
Here is a brief review:
academic.oup.com/ecco-jcc/artic…
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Rabih Geha
@rabihmgeha
1/The base rate…a double-edged sword.

A mini-tweetorial on this crucial concept in clinical reasoning.
2/What is it?

The base rate is the relative frequency of a diagnosis within a clinical context.

Example:
In the emergency room, what % of patients with dyspnea have a pulmonary embolism?
3/
 What’s the deal with the clinical context?

The base rate is function of the clinical syndrome being considered.

The frequency of a disease in an incompatible clinical syndromes is close to zero.

Example:
The rate of PE in patients with acute dysuria is nearly zero.
Read 8 tweets

Related threads

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Arjun Arya, MD, MSc.
@aryadoctoryet
#medtwitter #tweetorial on one of my favorite, elegant little mechanisms. This is something every #resident and #medstudenttwitter will see ALL the time! Bonus inclusion: a simple way to think about macro/micro-cytosis.

So, why is basically everyone in the hospital anemic?

1/
Principles:

- it is useful to remember that the venous blood “drawn” for a lab test is composed of many parts: plasma, RBCs and WBCs.

- Hemoglobin (Hgb) is a direct measure of the actual Hgb molecule within the RBCs

&

- hematocrit (Hct) is the % volume of RBCs

2/
So why can we “cheat” and just multiply the hemoglobin by 3 to get the hematocrit?

Well - in a healthy RBC, approximately 1/3 of its space is a hemoglobin molecule!

So, imagine each RBC as just a Hgb molecule wearing a coat! The Hgb is 1/3 of the space, the coat 2/3s!

3/
Read 17 tweets
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Guy Leschziner
@guy_lesch
#medtwitter 2020 marks a decade of me being an NHS consultant, and has led to much reflection. There are things I wish I had been told before starting my post, and I have put a few of these together, some minor but some v important -
1/ Burnout is your biggest enemy - physical but more significantly emotional. When you first start, the tendency is to say yes to everything that is asked of you. Choose carefully, and only say yes to the things you really want to do, as you will end up doing them for a long time
2/ Embrace saying "I don't know" - it is not a sign of weakness, rather of being a good doctor and knowing your limits. Ask for help - refer for a second opinion, ask a colleague - you will learn something, and reduce the stress of uncertainty
Read 12 tweets
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Hansika Hanthanapitiya
@HansikaHH
Hello guys, small Sex-Ed thread on Oral Sex!  

A lot of people seem to think it's only enough to use protection when having penetrative sex and don't use protection during oral sex. Well, it's NOT safe! 

#SexEd #PatientEd #medtwitter #lka

Picture - Google images
Try to avoid having oral sex with strangers or new partners without protection because you don't know what diseases they're carrying that could be transmitted through oral sex

#SexEd #PatientEd
Diseases that can be transmitted through oral sex: 

¤ HIV 

¤ Chlamydia

¤ Gonorrhea

¤ Syphilis

¤ Herpes

¤ HPV (human papillomavirus)

¤ Trichomoniasis

More the frequency, greater the chance of contacting these diseases.
Read 6 tweets
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Howard Luks MD
@hjluks
#medtwitter #orthotwitter Let's educate each other !
MIddle aged Shoulder Pain ...
The vast majority of shoulder issues that arise in middle-aged folks do not have a traumatic etiology. They are treated differently than traumatic shoulder issues. What are the most common Dxs?
"impingement" -Plz stop using that term. The lit has proven it doesn't exist. The dreaded "bone spur" is not a cause of shoulder pain. Subacromial pain syndrome probably a better name. Typical presentation: Pain along lateral prox humerus. Strength is often normal... 2/?
You should X-ray them... takes calcific tendonitis, OA, tumors, etc off the table. If strength is normal, do not send them for an MRI. Mny ppl at this age have rotator cuff pathology in BOTH shoulders... and ppl can't unsee their MRI report. howardluksmd.com/sports-medicin… 3/?
Read 21 tweets
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Sayna Norouzi, MD
@SaynaNorouzi
Another day on service and you are starting with answering a page from PACU. "Hi this is nephrology fellow returning your page". "Great! This is Ortho, and our patient post op has low potassium here; I believe you call it HYPOkalemia" #Loveourorthopods #Tweetorial #medthread
Join us for our electrolyte abnormality du jour and learn how to break it down! #nephtwitter #medtwitter #FOAMED See our full post @RenalFellowNtwk > renalfellow.org/2019/11/14/the…
59 yo F with a hx of HTN, and HLP admitted for a left femur fracture; she was found down by her neighbor 3 days after her fall; awake and in pain. Now, patient is post op; and on labs: (baseline cr: 0.51). UA unremarkable.
Read 19 tweets
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Briana Ruíz Christophers
@BriChristophers
#MedTwitter has been discussing “Take Two Aspirin + Call Me By My Pronouns,” an op-ed claiming social justice is taking time from sci ed + decreasing the quality of #MedEd.

So here’s my take:
“Take Two Aspirin + Read a Curriculum”
THREAD.

#MedTwitter #SoMeDocs #DoubleDocs
As always, I start threads with my POV: #LatinasInMedicine #DoubleDocs student in year 2 of #medschool. I have interests in both #MedEd + #HealthJustice. I am about to finish my term as diversity rep on our med student govt. I care a lot about advocacy.
Let’s take a moment to learn about the author: Stanley Goldfarb is a nephrologist, *former* assoc dean of curriculum at UPenn Med. He graduated from med school in 1969. Ffolks who studied at UPenn have brought up negative experiences with Dr. Goldfarb.
Read 55 tweets

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