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13 Oct, 5 tweets, 4 min read
1/🚨 New #MindtheGap Episode🚨

#MedTwitter, Can you use oral diabetes meds in the hospital? If so, which ones?!

🎶Listen on any podcast app!
iTunes: bit.ly/coreimpodcast
Show Notes: bit.ly/3mGXXRG
CME/MOC: bit.ly/3oVhwbI
2/ What about DPP-4s?

Usually well tolerated because they ONLY release insulin with a glucose load

So we don’t have to be too concerned if the patient will be NPO!
3/ What about GLP-1s? They act similarly to DPP-4s.

When should we avoid GLP-1s?
4/ What about SGLT-2 inhibitors? #Flozinators

Here we do have to be mindful to PO intake inpatient and possibility of euglycemic DKA
5/ Kudos to the amazing team |
Hosts: @SatyaPatelMD, @TylerLarsenMD | Expert: Dr. Guillermo Umpierrez | Peer Review: Dr. Jane Weinreb, Dr. Amanda Klinger| Graphic: @mike_natter | Audio Editor: Max Had

#MedTwitter, Like, Comment, Retweet with your practice with oral DM meds inpt!

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More from @COREIMpodcast

CORE IM Profile picture
7 Oct
1/ Good morning #MedTwitter, it’s time for another episode of #12LeadThursday! Remember to approach every EKG systematically. Grab your calipers, and let’s dive in!

What are potential causes of this pause?
2/ We can think about pauses in three buckets below. We’ll get into why we think a PAC is causing the pause above, but stop for a moment and consider: what would the EKG look like if AVN blockade or sinus node dysfunction were at play?
3/ In the above EKG, we see the PAC hiding in a T wave! This PAC reset the SA node, and a pause was born!

Before we move on: if the AVN is dysfunctional, how do you differentiate a blocked PAC from a dropped beat?
Read 5 tweets
CORE IM Profile picture
24 Jun
1/ Good morning, #medtwitter, and happy Thursday! We’re excited to bring you our latest edition of #ReadingRoom. Dim the lights, and get ready to clinically correlate!

You’ve got two abdominal plain films below. Which one is from a patient with a SBO?
2/ Let’s take a closer look, starting with the image on the right: here, there’s no abnormal dilation and the distribution of gas is normal. This is a normal abdominal film.
3/ On the other hand, here we see an abnormally dilated small bowel with predominant small bowel gas while there is no rectal gas and scant colonic gas. This is concerning for a SBO.
Read 7 tweets
CORE IM Profile picture
13 Apr
1/ Good morning, #MedTwitter, and happy Tuesday! We’re excited to bring you our latest installment of #ReadingRoom today. Dim the lights; it’s time to clinically correlate!

What object is labeled in the CXR below? What is it used for? Image
2/ That, friends, is our dear friend: the NG tube. It is our portal for tube feeds and PO meds (technically Per Nasus?), or if you put the thing down flip it and reverse it you can use the NGT to decompress the stomach. Image
3/ Next question: should you place that order that says “OK to use NG tube”?

The graphic below shows a systematic approach to ensure correct placement. This one is good to go! Image
Read 6 tweets
CORE IM Profile picture
25 Mar
1/ #MedTwitter Today, March 25, we want to remember the Medical Committee for Human Rights (MCHR), a branch of the Civil Rights movement. Image
2/ MCHR recognized the fundamental inseparability of fight for racial justice and the fight for health equity. Image
3/ MCHR no longer exists in name, but it lives on in the legacy of institutions like @PNHP and @P4HR.

So, #MedTwitter, consider this a call to action: what are you doing to promote equity in healthcare today? Image
Read 4 tweets
CORE IM Profile picture
13 Aug 20
1/ It’s Thursday, #MedTwitter, which means it’s time to take out your calipers and get to business. It’s #12LeadThursday!

Remember to use your system to go through each and every ECG methodically.
2/ Rate: ~75bpm
Rhythm: NSR
Axis: ...
3/ Do you have a schema or framework for thinking about a right axis deviation? What’s your differential?

Let us know in the comments below, and check out the framework we’ve provided!
Read 7 tweets
CORE IM Profile picture
16 Jul 20
1/ Welcome back, #medtwitter, to the latest installment of #12LeadThursday - #covid19 edition! Let’s put those calipers to work!

Take a look at this ECG. Approach it systematically. What do you see?
2/ In the above ECG, you’ve got an irregular narrow complex tachycardia. What’s your final read? Reply with your reasoning!
3/ Let’s take a closer look. In the graphic below, we’ve highlighted what you would expect to see in flutter - and none of it is present here. Our patient is fibbin’ away, folks.
Read 6 tweets

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