Allison Hempenstall MD MPH Profile picture
Apr 17, 2020 7 tweets 6 min read Read on X
1/ Primary Care Case of the Week

#MedStudents clinical placements have halted due to the #COVID19 pandemic. So I’d like to share an interesting case each week to support #MedStudents clinical reasoning.

🧐All cases are factitious, but inspired by cases seen in #PrimaryCare Image
2/ Before we begin, what is clinical reasoning?

💡It’s an ability to integrate & apply different types of knowledge, to weigh evidence, critically think about arguments & to reflect upon the process used to arrive at a diagnosis

#MedEd #MedTwitter
nap.edu/read/21794/cha… Image
3/ Do you have a diagnostic strategy?

💡Make sure you structure your differential list & practice using it with every case!

📝Here’s Murtagh’s PROMPT:
P=Probable diagnoses
R=Red flags
O=Often missed
M=Masquerades
T=patient trying to Tell me something

4/ Primary Care Case Week 1

15yo M presents to a remote clinic in the #TorresStrait with a right foot wound. It’s been there for 1 month & he can’t remember any injuries.

💡What’s in your list of differential diagnoses?

💡What would you like to know on history & exam? Image
5/ #Yaws
🦶🏾#NTD Treponema pallidum subsp. pertenue
🦶🏼Identical morphology to syphilis
🦶🏿Transmitted through nonsexual contact with skin lesions
🦶🏽Painless erythematous papule that ulcerate
🦶🏾Diagnosed by darkfield microscopy/syphilis serology
🦶🏻Treat with benzathine penicillin G Image
6/ Check out more about this neglected tropical disease:

💻who.int/yaws/disease/e…

🎥

👉🏽Follow Yaws leading world expert @dr_michaelmarks
7/ Thanks to everyone who played along this week! I’ll post another next week 💁🏻‍♀️

👉🏽Here are additional great online resources for #MedStudents to aid your learning:

onthewards.org
dontforgetthebubbles.com
osmosis.org/library

@onthewardsorg @DFTBubbles @OsmosisMed

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More from @Dr_Hempenstall

Sep 25, 2020
1/ Now that I’ve transitioned back to being a full time student (🤯), I’ve taken on a personal challenge to read one academic journal article each day.

🧐 So #MedTwitter #AcademicTwitter, how do you critically & effectively read a journal article? Image
2/ The 3-pass approach to reading a scientific article:

1st pass: quick scan of the article

2nd pass: read it in detail, highlight & jot down notes as you go

3rd pass: in dot points, try & reconstruct the main points of the paper from memory including your critical analysis
3/ Here is another approach:

elsevier.com/connect/infogr… Image
Read 6 tweets
Jun 22, 2020
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
Jun 5, 2020
A thought provoking question from a medical student today as we discussed #CrazySocks4Docs:

“We all walk around wearing socks & I know it’s gotta do with mental health, but really...does it make any difference? What’s the use?”

So here is the difference I see: Image
💁🏾‍♀️Increased awareness of mental health in doctors

Did you know:
📌21% doctors have had depression
📌Medical students report higher rates of general distress & specific mental health diagnoses
📌1:4 doctors had suicidal ideation prior to the last 12months

beyondblue.org.au/docs/default-s…
💁🏻‍♂️Increased health professionals mental health funding for research & support

👏🏽$500K additional funding for doctors mental health support @VDHP3

👏🏾 Breakthrough Mental Health Research Foundation are also raising funds for doctors mental health research
https://t.co/sJNhyeTwAy
Read 5 tweets
May 15, 2020
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
May 8, 2020
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
May 1, 2020
1/ Primary Care Case of the Week 3

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/ 30yo crayfish diver presents to the clinic with sudden onset abdominal, back & chest pain. He looks sweaty & in significant discomfort.

🦞What’s in your list of differential diagnoses?

🦞What would you would like to know on history & exam?

#MedEd Image
3/ Irukandji Syndrome

📌Caused by sting of Carukia barnesi jellyfish found in coastal waters of tropical Australia

📌Envenomation thought to induce massive catecholamine release

📌Initial sting usually not felt! Image
Read 6 tweets

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