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Mar 3 5 tweets 3 min read
1/ Good morning #MedTwitter ! It’s time for #12LeadThursday

Let’s jump in– can you decipher the EKG below to find out what’s wrong with this patient’s His-Purkinje system?
2/ If you thought left anterior fascicular block (LAFB), you were right!

What is the formal criteria for LAFB?!
✅Left axis deviation w/o LVH
✅qR pattern in lead aVL
✅R-peak time in lead aVL of 45 ms or more
✅QRS duration less than 120 ms
3/ Why do our patients get LAFB?!

Think fibrosis in the left anterior fascicle! This causes a slowed electrical conduction → EKG findings.
4/ Clinically, what do we do when we identify a patient with LAFB?

☑️Ask why! Think about causes for fibrosis, particularly hypertension or structural heart disease

☑️Stay vigilant! LAFB has corresponded to increased risk of cardiac problems like Afib or HF
5/ That’s all for #12LeadThursday folks. Thanks to the author Sam Maidman, graphics by @Preeyal_P and @gregorykatz for review

Thanks again #medtwitter; like & reply with questions or comments!

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More from @COREIMpodcast

Mar 1
1/ Good afternoon #MedTwitter and happy #TriviaTuesday :

What part of a plane are you most likely to come into contact with bacteria? ✈️
2/ And there you have it… the armrest!

Not what you expected? Read on
3/ We’re familiar with the ways infections can spread- contact, droplet/airborne, vector, and food/water.

We’re going to focus on contact precautions today:
Read 5 tweets
Feb 23
1/🚨New Episode & Segment Alert🚨

Grey Matters: Because medicine is rarely black and white!

Hosts: Alison Trainor, @FreedoBaggins
Discussants: @PishkoMD, Brett Carroll MD, Jeff Weinstein MD
Graphic: @samwoodworthmd

🎶 bit.ly/35hN1Fd
ACP: bit.ly/3oVhwbI
2/ Let's review some deep dives 👇

Where does the *strong rec* to anticoagulate for PE at least 1 month (if not the full 3 months) come from?!

We have natural history data tells us:
3/ How long do you hold DOACs for peri-procedure?

Let’s see what we can extrapolate from the PAUSE trial
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Feb 15
1/ Good morning #MedTwitter and welcome back to #TriviaTuesday

Let’s start with our question of the week👇 Image
2/ And the answer is: Pneumo-Ultra-Microscopic-Silico-Volcano-Coniosis

Say that 5x times fast! Image
3/ Silicosis is a lung disease caused by inhalation of silica dust.

Workers in what industries should perk your clinical ears for considering silicosis? Image
Read 6 tweets
Jan 5
1/ 🚨New Episode! 🚨

What is an “appropriate” Hgb bump?

Why do we usually say 1g/dL for 1 pRBC?

iTunes: bit.ly/coreimpodcast
Show Notes: bit.ly/3eUgyGw

First, let’s figure out how many grams of hemoglobin are donated?
2/ What is the patient’s PRE-transfusion #intravascular volume?

Usually 6.5% of body weight for women 👩
Usually 7.5% of body weight for men👨
3/ What is the patient’s POST-transfusion intravascular volume?
Read 7 tweets
Dec 28, 2021
1/ #MedTwitter, welcome back to our #TriviaTuesday series

Today's question:
What disease is prevented by the "4-inch law"?

Hint- the reservoir/host is 4 inches...
2/ Non-typhoidal salmonellosis is prevented by the "4-inch law" !

What is the "4-inch law" ? Keep scrolling to learn more!
3/ The U.S. FDA bans the sale of small turtles <4 inches in length.

Did you know that turtles GI tracts are colonized with non-typhoidal Salmonella and often pet turtles swim in their feces?!
Read 6 tweets
Nov 17, 2021
1/ 🚨New Episode Alert🚨
Bringing you the latest edition of #MindTheGap: Hyperkalemia in CKD

Available on any podcast app:
iTunes: bit.ly/coreimpodcast
Show Notes: bit.ly/3Hrkwn0
CME/MOC: bit.ly/CIMCME Image
2/ Learn more about pseudohyperkalemia

Can there be pseudohyperkalemia if the lab doesn’t report it as #hemolyzed?!

What happens with whole blood collection that ⬇️ chances of pseudohyperkalemia?!

Sounds like you want to Keep listening right #MedTwitter ?... Image
3/ #MedTwitter, what have you learned in the past about restricting potassium in the diet in the context of CKD?

Talking with @sjoshimd, we discussed his approach, especially since high K foods have significant CV benefits, especially for those with CKD. Image
Read 4 tweets

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