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Mohit Harsh, MD Profile picture
Mohit Harsh, MD
@MohitHarshMD
Hospitalist. Former Chief Resident @WashUIMRes via @MUSOMWV. Interested in Clinical Reasoning and #TWDFNR. #Zenternist
Jun 13, 2022 • 13 tweets • 6 min read
It is unfortunate that this attitude re: IM. It is a distinct reason many dislike their experiences on ward teams

It doesn’t have to be this way, but it is our fault as a specialty that this idea persists in 2022

A 🧵… First, a question:

From your experiences, why are internal medicine rounds so long?
May 9, 2022 • 4 tweets • 6 min read
May 9th = Tip #9 #TipsForNewDocs #MedTwitter

One of the biggest lessons from intern year is getting a gestalt for sick vs not sick

This relies on recognizing signs and symptoms that should give you pause

A brief list and crowdsourcing to add to this list! Tachycardia in a pt w/ HFrEF

Back pain in a pt w/ MRSA bacteremia

Nausea/vomiting in a pt w/ T1D

Syncope on exertion

Syncope while at rest

A non-healing wound in a pt w/ diabetes

Confusion in a pt w/ cirrhosis

Failure to thrive in an older pt

Recurrent falls
May 4, 2022 • 16 tweets • 12 min read
May the 4th be with you! Tip #4 #TipsForNewDocs #MedTwitter

You’ve probably heard this one time and time again: “read more” or “read up on your patients”

Yet no one tells you HOW they read more and make that information stick!

A 🧵 on the system I developed in residency I have a terrible memory so I have to brush up constantly

Being told to read more was daunting because the amount to read was overwhelming and I may only retain 10% of the UpToDate article, etc

There are 3 areas I focus on

Dx reasoning
Rx reasoning
Patient Centered EBM
Oct 23, 2020 • 13 tweets • 11 min read
Hey #MedTwitter fam!

Time for the inaugural #MedDermTwagTeam #tweetorial on #Scleroderma

This is a diffuse (get it?) topic so @RashDecisionz & I will try to keep it focused

I’ll tweet on illness script

S/O to @CPSolvers @MedEdTwagTeam and many others for the inspiration!
1/12 Who else gets confused with the terminology? I sure do

The confusion may arise because scleroderma is a spectrum of disorders. Also, people say Scleroderma interchangeably with #SystemicSclerosis

The subtype is based on extent of skin & organ involvement

2/12 Image
May 1, 2020 • 11 tweets • 8 min read
As promised, pt 2 in Potassium #Tweetorial series. This time, Aldosterone and Potassium Homeostasis

Another large physiology topic, so I’ll be brief and stick to highlights from reading #BurtonRose textbook, which I highly recommend for all levels of learner

Thread ⬇️ Aldo is well known to provide Internal Balance of K after oral intake or fluctuation in [K]

Aldo works by augmenting K secretion in principal cells. After K load, Aldo is directly enhanced and contributes to kaliuresis via changes in Na and K channels and Na-K-ATPase activity
Apr 28, 2020 • 8 tweets • 5 min read
Time for my first #medtwitter #Tweetorial on Insulin and Potassium regulation!

This is part 1 of a tweetorial series on K homeostasis/Hyperkalemia. This is a big topic, so I’ll stick to concepts.

Poll: What percent of total body Potassium is within extracellular fluid? The answer is only 2%!

That means shifts of even small amounts of K either in or out of the ECF leads to huge changes in plasma K concentration.

A great way to think of K regulation is external and internal K balance.

This interplay was described in a 1978 NEJM review