1/5 Myths in Medicine:
1.Docusate is an effective laxative
2.Oral iron requires TID dosing
3.HCQ for treatment of #COVID19 4. ๐๐ต๐ฎ๐น๐ธ ๐๐ฎ๐น๐ธ๐ ๐ฎ๐ฟ๐ฒ ๐ฒ๐ฎ๐๐ ๐ฎ๐ป๐ฑ ๐ฒ๐ณ๐ณ๐ผ๐ฟ๐๐น๐ฒ๐๐
2/5 The best #chalktalks are succinct, spontaneous, and seemingly breezy. But that does not mean they donโt require hard work! Anything that looks easy and effortless actually took hours of preparation and repetition. #PrepandReps
4/5 Confession: it took me 8hrs to prep my 1st morning report teaching points as a chief resident. @StanfordChiefs@AshishSarraju@DrMitaHopp
I am faster now but still spend hours to create each โchalk talkโ (albeit w/o chalk); I revisit it with each iteration to improve it.
5/5 Letโs debunk the myth that chalk talks (&teaching) are easy and effortless. You donโt need to be a master clinician, but you do need โ๏ธand ๐. If youโve ever thought about creating a โchalk talkโ, today is as good of a day as any. And remember: itโs all about the #PrepandReps
โข โข โข
Missing some Tweet in this thread? You can try to
force a refresh
1/15 #MedTwitter: You're admitting a 64YO male with ESRD on HD for hyperkalemia after missing dialysis. A troponin was checked & returned at 0.78 (nl<0.055 ng/mL), similar to his baseline. He is w/osymptoms and EKG is w/o dynamic changes. What would you call this #tropbump?
2/15 Have you ever been taught to think about troponin as being cardiac vs. non-cardiac in origin? Though this may be a nice framework, itโs simply untrue: if youโre measuring cardiac troponin I (cTnI), it is expressed only on myocardium(not skeletal muscle, unlike troponin T).
3/15 The lexicon to describe troponins is confusing!
"๐๐ณ๐ฐ๐ฑ๐ฐ๐ฏ๐ช๐ฏ๐ฆ๐ฎ๐ช๐ข" is frequently used but is not very helpful. It is NOT a diagnosis or etiology, and should probably be abandoned as a term altogether.
#MedTwitter: It is switch weekend/Friday! How do you like to sign-out your patient list to the oncoming physician?
I was once a proponent for the email sign out: putting words to paper (or screen) helped me organize my thoughts. And frankly, was more convenient.
But recently, I signed out to my colleague via phone and ๐ it!
We ended-up talking not only about the patients on our list, but past experiences on similar undifferentiated/challenging cases, and our emotional/psychological well-being during present times.
I now prefer signing out via ๐ and encourage you to try it as it:
UFH is a negatively charged, heterogenous mix of oligosaccharides. Heparin MUST bind antithrombin (AT) to have an anticoagulant effect. AT then inhibits Xa, thrombin (II), and other proteases.
1/14 #MedTwitter: The ED pages you for an admission: a 24-year-old male with a history of IVDU presenting with fever. How do you take his drug history?
2/14 As a resident, I fell into A + B, until @cuttingforstone taught me you need to know a lot more to appropriately Dx and Tx your patient. My mnemonic?
๐๐ฅ๐จ๐: Drug, Route, User, Goods.
3/14 Buckle up for a deep dive into why a detailed drug history matters!
2/9 We reviewed her admission EKG. What do you notice?
3/9 #MedTwitter: Whatโs your ddx for low EKG voltage? Think back to physiology. The space between EKG leads &โค๏ธ can be filled with: ๐ณ๐น๐๐ถ๐ฑ (pleural/pericardial effusion), ๐ฎ๐ถ๐ฟ (PTX, COPD), ๐ณ๐ฎ๐, ๐ถ๐๐ฐ๐ต๐ฒ๐บ๐ถ๐ฎ (dead tissue) or ๐ถ๐ป๐ณ๐ถ๐น๐๐ฟ๐ฎ๐๐ถ๐๐ฒ processes.
1/8 Weโve all had that moment as learners when we think weโve detected a key physical exam finding, and upon returning with the attending: that rash, cool extremity, or tremor has gone away.
2/8 @VillarPrados told me a great catch he made his intern year. He was admitting a gentleman with syncope. He heard a loud systolic murmur during cardiac auscultation and ordered an echocardiogram.
3/8 He presented the patient and this exam finding to his attending hours later. When they arrived at bedside to examine the patient, the murmur disappeared! At this point, @VillarPrados is feeling meek and second guessing himself. ๐ณ