Medicine Podcast || Inspiring curiosity & critical thinking || 5 Pearls || Mind the Gap || Hoofbeats || At the Bedside || Gray Matters || Biweekly Wed.
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Sep 11 • 8 tweets • 2 min read
1/ 🚨 NEW #AtTheBedside: Moral Distress Part 1: Definitions, Causes & Consequences
Time to really name, talk about, and hopefully unpack some of the hidden weight we carry in the practice of medicine ⤵️
When clinicians are:
☀️ Stopped from taking what they believe to be ethically appropriate actions
☀️ Forced to take actions that are ethically inappropriate based on their professional obligations
Results in a sense of complicity & wrongdoing
Jun 5 • 7 tweets • 2 min read
1/ 🚨 NEW #5Pearls on HFpEF!
HFpEF is:
- Clinical syndrome of heart failure w/ EF 50%+
- ☂️ term | Heterogeneous disease
HFpEF is NOT:
- Classic high BP, causing stiff ventricles
#Insulin#MedTwitter2/ The #RABBIT2 study looked at the (1) efficacy and (2) safety of basal-bolus vs. sliding-scale #insulin in non-critical inpatients🏥.
Basal-bolus regimens consisted of a combo of #Glargine (basal) and #Glulisine (mealtime).
Have you ever been confused about what contrast #protocol to order?! 💭
“Protocols” = which phase of contrast is best evaluate the structure you are trying to see 🔎
Keep an eye on the white contrast being injected in this 🧵 2/ What are some different contrast protocols?
Compare and contrast the different protocols below ⬇️ and think about which clinical situations we use them in
Sep 29, 2022 • 6 tweets • 3 min read
1/ 🚨NEW PATIENT!🚨 66 y/o M found in his home unresponsive and hypothermic.
What abnormalities do you see in this EKG? 2/ Did you notice sinus bradycardia? What about intraventricular conduction delay?
Check out this slide with all 5 EKG findings!
Sep 15, 2022 • 6 tweets • 2 min read
🚨Your pager is going off!🚨 80M w h/o CAD on the inpatient medicine floor reporting burning epigastric pain after eating.
Here is his EKG:
Take a look…any notable findings on this patient’s EKG?!
Aug 17, 2022 • 9 tweets • 5 min read
1/ What are 3 Qs you can ask yourself when looking at non-inferiority trials?
Q1) Was the trial planned i.e. pre-specified as comparing an intervention which is non-inferior to control?
WHY?
Bc changing the analysis *afterwards* introduces bias #StatswithCoreIM2/ Q2) was the control treatment administered to the full std of care?
The trial relies on strict adherence to full standard of care for the control arm, otherwise the whole confidence interval shifts with a relative⬆️in benefit of the intervention compared to control
What would you tell this patient who inquires about lab cancer #screening test to help him “live longer”?
What types of bias can occur in determining whether a cancer screening test reduces mortality? 2/ Take a look at the bolded arrows below that illustrate that early detection doesn’t always mean better outcomes!
Length-time bias applies to slow-growing disease in which patients have a long phase without symptoms.
We wanted to use this opportunity to shed light on the discussion on post-menopausal hormone therapy (HT) via highlighting the important yet controversial WHI trial 2/ WHI followed the Nurses' Health Study, a prospective investigation that showed HT was associated with decreased cardiovascular disease (CVD) risk
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