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NephroPOCUS Profile picture
@NephroP
Dec 28, 2022 • 8 tweets • 6 min read • Read on X
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#POCUS puzzle 🧩of the day. Can you put together the pieces and arrive at an unifying diagnosis? Go through the thread 🧵below.
Context: #dialysis patient, physical examination #FOAMed #Nephrology #MedEd

Image No. 1 👇
Color #POCUS
Transverse #POCUS , IVC trace down
Transverse/oblique #POCUS color
Cardiac #POCUS
LVOT VTI #POCUS
Can you list all the abnormal findings? are they linked?
Cc some #POCUS friends who may find it relevant
@khaycock2 @IM_Crit_ @ArgaizR @katiewiskar @MDBeni @msiuba

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More from @NephroP

NephroPOCUS Profile picture
Mar 26
#eVExUS (= extended #VExUS) includes evaluation of additional veins when the original 3 veins are unobtainable or unreliable for any reason.
Below👇🧵 is an illustrative case showing abnormal pattern in all these veins.
#POCUS #FOAMed #Nephpearls
1⃣ IVC #ultrasound: dilated Image
2⃣ Hepatic vein #Doppler
Systolic flow reversal #POCUS #VExUS Image
3⃣ Portal vein #Doppler
100% pulsatile Image
Read 14 tweets
NephroPOCUS Profile picture
Nov 15, 2023
#echofirst views used to evaluate the right heart.
From ASE comprehensive echocardiography textbook/2010 guidelines
#POCUS #MedEd #CriticalCare #IMPOCUS
(🧵of 5 tweets) Image
#POCUS Image
#POCUS Image
Read 5 tweets
NephroPOCUS Profile picture
Aug 12, 2023
Common #echofirst views used in the #POCUS setting, image acquisition pearls and structures visualized.
Thread below🧵
Courtesy, ASE TTE guidelines 2018
#MedEd #FOAMed #FOAMcc
1⃣ Parasternal window Image
2⃣ Parasternal window continued Image
3⃣ Parasternal window, short axis plane
Often underutilized, can get an idea of TR when apical window is difficult, can do RVOT Doppler as well Image
Read 11 tweets
NephroPOCUS Profile picture
Jun 27, 2023
Focused question: Is HTN in a #dialysis patient always⬆️ intravascular volume? Remove💧?
Clinical: ESRD due to polycystic kidney disease, BP 160s/~100, IVC not well-visualized.
Next step to assess RAP: #VExUS
Below is hepatic vein Doppler
#POCUS #Nephpearls #FOAMcc
Follow the🧵 https://t.co/xZe23bHvJVtwitter.com/i/web/status/1…
2/ 👆What do you think?
3/ 👆HV #VExUS is showing resiprophasic D-reversal.
We commonly talk about S-reversal. Where do you see D-reversal? - constrictive pericarditis, tamponade, some cases of severe pulmonary HTN.
Next step: Evaluate the🫀
👇PV looks fine
Read 21 tweets
NephroPOCUS Profile picture
May 12, 2023
Cardiac #POCUS views - image acquisition pearls from JACC POCUS workbook
#MedTwitter #Nephpearls #FOAMed
Thread🧵below:
1/ Image
2/ Image
3/ Image
Read 4 tweets
NephroPOCUS Profile picture
May 10, 2023
#POCUS enthusiasts, is this IVC normal, abnormal? (asking about possibilities, not definitive conclusions)
#FOAMcc #MedEd #Nephpearls
(Transverse view in thread)
IVC transverse #POCUS
#POCUS answer:
I deliberately avoided clinical context in the original tweet to gather multiple opinions.
Image obtained from a thin, trained athlete with resting HR in 40s-50s.
A dilated IVC is commonly seen in this setting with no right heart pathology. In addition, particulate… twitter.com/i/web/status/1… Image
Read 5 tweets

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