(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
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!
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/…
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
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
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
1️⃣Look for exam findings
2️⃣Take a good family history
3️⃣Consider risk stratification with apoB, hsCRP, Lp(a)
4️⃣Tx to LDL < 100
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
📌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
💥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
☝️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
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
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!
💥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!
