(Thread) Another week and another @MedTwitThisWeek #medthread. As a reminder, this is not all inclusive. It's a jumping off point. A continuation of the discussions from the week that I found interesting including conferences, #Tweetiorials and tributes. #medttw #FOAMed
2/ Conference Bonanza! Since last week, several amazing conferences took place (or just started). Each conference has their own hashtags and flavors of #SoMe. Here are some highlights...
3/ @jenreadlynn was at #midwesthospmed and did a great job of distilling @MelBreggs' talk on inpatient management of alcohol withdrawal.
4/ My takeaways:
1️⃣Our words matter, avoid stimatizing language
2️⃣PAWSS is a great predictor of clinically relevant alcohol withdrawal symptoms
3️⃣Symptom-triggered treatment with BDZs preferred
4️⃣Consider non-BDZs like phenobarb

5/ As a conference that gave me the most amount of #FOMO #midwesthospmed also had @kimche present several hospitalist topics. She graciously wrote a companion thread to her talk.
6/ My takeaways:
1️⃣LR & Plasmalyte probably fluid if choice in most cases
2️⃣Is Contrast Associated Nephopathy a thing? At the very least think about other DDx for AKI in patients w/ GFR< 30
3️⃣Probably K > 3 ok in non-cardiac patients
💥Check out her poem!
8/ Of course the conference that really hit it out of the park in terms of #SoMe presence and the ability for me to attend virtually was @accpchest's #Chest2019.
9/ Not only where many participants tweeting, but #Chest2019 sessions were available to stream for free (as in beer).

Check out my @OSUWexMed colleague @DrQuinnCapers4 give the keynote address on #ImplicitBias here: chesttv.org/courses/14244/…
10/ Next is my weekly reminder to use the bookmark function in Twitter. @rabihmgeha's moments collection of his schemas and musings should be saved for later reference.
11/ @travisbenson teaches about clozapine from his psych rotation:
1️⃣Efficacious but limited because of side effects
2️⃣Monitored by REMS
3️⃣Neutropenia must be closely monitored
4️⃣ ⬆️ rates of 🚬 use by those w/ schizophrenia is challenging when prescribing
12/ @adairalandrymd's touching tribute to her friend and mentor @dr_uche_bee should not be missed.
13/ @audreybjernigan shares some morning report pearls about familial hypercholesterolemia.
1️⃣Look for exam findings
2️⃣Take a good family history
3️⃣Consider risk stratification with apoB, hsCRP, Lp(a)
4️⃣Tx to LDL < 100
14/ @therealdoctort examines his own mortality in his prose this week:
15/ @nephromd discusses how to predict which SIADH patients may not respond to fluid restriction alone.
16/ My Takeaways:
📌Up to 70% will not respond
📌U/P ratios > 1 means pt is retaining water and will need additional therapy
📌UNa >= 130 and Uosm >= 500 are also predictors of non-response
📌These patients will need additional therapy like urea or Vaptan
17/ Another Neph related thread came courtesy of @kidney_boy who presented an interesting case of worsening hyperkalemia.
18/ Takeaways:
💥Consider pseudohyperkalemia if WBC > 100k or Plt > 100k
💥Lymphocytes in CLL are fragile➡️release intracellular potassium easily
💥Try checking K on blood gas machine instead because sample heparinized
20/ My colleague @justinberk recently published a @TWDFNR article for @JHospMedicine. My takeaways when dealing with an infants <60 days old & bronchiolitis.
21/ Takeaways:
☝️Most febrile infant risk stratification algorithms have high negative predictive values
✌️Concomitant viral infections further decrease the pretest probability
🤟Since LP risks are not minimal, we should avoid LPs in this select population
22/ Check out @GIMaPreceptor's discussion of cognitive bias...
23/ What do you know about histo antigen testing? @txid_edu gave us an epic thread this week.

Takeaways (thread & replies):
1️⃣Poultry can be a vector (birds)
2️⃣Urine antigen > Serum (debatable if combining ⬆️ sensitivity)
3️⃣Low-positives can happen
24/ Check out this great video example by @UCSFIMChiefs of "cannon a waves" due to (redacted).
25/ @MKIttlesonMD started a great discussion on misconceptions she embarrassingly had in training. This is definitely worth scrolling through all the comments for others' anecdotes.
26/ @gradydoctor enlightens us again with her digital mentorship. This time on how to give feedback.
27/ My takeaways:
💥Acknowledge your own biases
💥Expectations - be clear/explicit
💥Timing - feedback types include on-the-fly, midpoint, end-of-period
💥Intention - Tell them why! To improve!
29/ Thanks for tuning in for another week of #Medtwitter highlights. Please reply with your own favorites! A quiz will come out midweek to help practice retrieval of some of the salient points.
Fin/ POLL - Did you learn anything? Also, reply with suggestions on how I can make this better
Oooops, sorry @TravisABenson, I somehow tagged the wrong handle. I'll fix it when Twitter gets an edit feature. Apologies!
Missing some Tweet in this thread? You can try to force a refresh.

Enjoying this thread?

Keep Current with Chris "The Chiu Man" Chiu, MD FACP FAAP

Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

Twitter may remove this content at anytime, convert it as a PDF, save and print for later use!

Try unrolling a thread yourself!

how to unroll video

1) Follow Thread Reader App on Twitter so you can easily mention us!

2) Go to a Twitter thread (series of Tweets by the same owner) and mention us with a keyword "unroll" @threadreaderapp unroll

You can practice here first or read more on our help page!

Follow Us on Twitter!

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just three indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3.00/month or $30.00/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal Become our Patreon

Thank you for your support!