Kirtan Patolia Profile picture
Team member @CPSolvers l PGY-1 @CookCountyIMR I Addicted to dissecting cases I Interested in IM & Clinical reasoning I Views my own #MedTwitter
Dr Manoj Chitale Profile picture 1 added to My Authors
May 27 19 tweets 11 min read
The spectrum of Marfan syndrome and related connective tissue disorders is intriguing and mind-bending 💫✨

Here is a🧵exploring it

@CPSolvers @rabihmgeha @DxRxEdu @Sharminzi @AnnKumfer @rav7ks @sargsyanz @DrCindyCooper @jackpenner @MatthewHoMD @ASanchez_PS

#MedTwitter #2 Skeletal manifestations

-Tall stature
-Long slender arms & legs
-Arachnodactyly
-Pectus excavatum
- Pectus carinatum
-Joint hypermobility
-Pes planus
-Camptodactyly (bent fingers)
-Kyphoscoliosis
-Micrognathia & Retrognathia
-Dolichocephaly
-Malar hypoplasia

#MedTwitter
May 7 8 tweets 6 min read
The journey to the diagnosis of Sweet syndrome and its differentials is too sweet 🍬🍩🍫

Let's explore the sweetness.

@rabihmgeha @DxRxEdu @Sharminzi @DrCindyCooper @jackpenner @sargsyanz @rav7ks @RebeccaEBerger @RosenelliEM @CPSolvers @MithuRheum #MedTwitter #rheumatology #1 Malignancies & Sweet syndrome

- AML (common)
- MDS (common)
- CML
- MM
- Hodgkin's lymphoma
- NHL
- Mycoses fungoides
- Cutaneous T-cell lymphoma
- Hairy cell leukemia
- Solid tumors

#oncology #hematology #MedTwitter
Apr 13 11 tweets 8 min read
Differential diagnoses of ⛈️Thunderclap headache⚡ are indeed thunderous.

Here is a brief 🧵.

@AaronLBerkowitz @caseyalbin @rabihmgeha @DxRxEdu @sargsyanz @AnnKumfer @rav7ks @gabifpucci @jackpenner @RosenelliEM @Sharminzi @CPSolvers

#MedTwitter #NeuroTwitter #Neurology #1 Subarachnoid hemorrhage

Aneurysmal SAH
Cortical SAH (due to RCVS)

- Seizures
- Meningismus
- Altered mental status
- RBC & Xanthochromia in CSF

Look out for possible
sequelae: Rebleeding, vasospasm & ischemia, hydrocephalus

#MedTwitter #Neurology

nejm.org/doi/10.1056/NE…
Dec 20, 2021 9 tweets 7 min read
Differential diagnosis of RA-like arthritis based on the pattern of joint involvement is fascinating

Here is a 🧵 exploring this journey

#medtwitter #RheumTwitter @CPSolvers @rabihmgeha @DrCindyCooper @DxRxEdu @Sharminzi @sargsyanz @rav7ks @RosenelliEM @AnnKumfer @jackpenner Various patterns of hand joint involvement

- PIP +DIP +1st CMC = OA
- MCP +PIP +Wrist = RA
- 2nd & 3rd MCP = Hemochromatosis
- Wrist +2nd MCP + 2nd PIP + all DIP= PsA
- Dactylitis/Sausage digits = PsA, Sickle cell anemia, Polyarticular gout, Sarcoidosis

#medtwitter @MithuRheum
Oct 28, 2021 9 tweets 4 min read
Not many entities in Medicine are as intricate as Paraproteinemias

As we celebrate National Internal medicine day today, here is a 🧵exploring its various associations and complications

#MedTwitter #hematology @AnnKumfer @RebeccaEBerger @Sharminzi @rabihmgeha @DxRxEdu @rav7ks Entities that can feature a monoclonal protein/M component:

-MM
-WM
-MGUS
-MGCS
-MGRS
-Splenic Marginal Zone Lymphoma (HCV)
-CLL & MBL
-Heavy Chain disease (Gamma, Alpha & Mu)

There are various others indirectly associated with the M component. More to follow
Oct 25, 2021 11 tweets 7 min read
Guillain barre / GBS has an interesting differential diagnosis that has crucial management implications

Here is a thread based on what I have learned from my dear residents, attendings & journals

#MedTwitter #NeuroTwitter @rabihmgeha @DxRxEdu @AaronLBerkowitz @rav7ks #1 GBS

- Infxs (C. jejuni, Mycoplasma, EBV, CMV, Zika,Influenza, HIV)
- Ascending weakness
- Cranial nerve involvement (CN 7)
- Usually no bowel/bladder disturbances
- Cyto-albuminologic dissociation and areflexia (may not manifest very early on)
- Rx - IVIG & Plasmapheresis
Oct 19, 2021 10 tweets 3 min read
Adult-onset Still's disease/sJIA is beyond fascinating. The myriad of symptoms it can present with overlaps with many other disorders

Here is a thread exploring its spectrum

Any suggestions appreciated

#MedTwitter @CPSolvers @rabihmgeha @DxRxEdu @sargsyanz @rav7ks Still's disease/sJIA classic symptoms
- Fever (Quotidian)
- Sore throat
- Synovitis/Arthralgia
- Hepatosplenomegaly
- Rash (Evanescent Salmon colored)
- Lymphadenopathy
- Anemia + Leukocytosis + Thrombocytosis + Hyperferritenemia + elevated ESR
- Rx (IL-1 inhibition)
Apr 26, 2021 8 tweets 4 min read
Inspired by recent posts from @AaronGoodman33 , here is my attempt to review briefly the interplay between Hematology and Autoimmune phenomena.

It's magic when that fusion occurs.

Any comments & suggestions appreciated.

#MedTwitter @rabihmgeha @DxRxEdu @CPSolvers CLL & Autoantibodies:

1.) WAIHA (IgG), CAD (IgM), PCH

2.) PRCA, Autoimmune Neutropenia

3.) C1-NH (acquired angioedema)

4.) GM-CSF (Pulmonary alveolar Proteinosis)

5.) Factor VIII, vWD, V (Coagulopathy)

6.) ADAMTS13 (TTP)

7.) CFH & CFI (aHUS)

contd...

#MedTwitter