The morbidly beautiful images of the genius Dr Frank Netter🎨

A visual thread🧵 Rabies

😱Challenges in medicine😱

Malaria🪰🩸

A short 🧵 Intro:
- caused by protozoa parasites of genus Plasmodium
- transmitted throughout most of the tropics
- in 84 countries and territories
- in 2023, WHO reported 247 million cases (up from 245 million in 2020)
- 619 thousand deaths (down from 625,000 in 2020)
1/

10 rules for life of a good mentor

A 🧵 Rule 1: Lead by example
As a mentor, your actions speak louder than words. Demonstrate the ethics, dedication, and passion you wish to instill in your mentees.

Practice what you preach🙏

😱Challenges in hematology😱

Crisis in sickle cell disease (SCD)

A short 🧵

1/15 Short intro to sickle cell disease (SCD):
-group of inherited red blood cell disorders
-affects ~ 1 in 500 African American and 1 in 36,000 Hispanic American children
-results in anemia
-main clinical feature is acute painful crisis
👉 often requires hospitalization
2/15

😱Challenges in hematology😱

acquired von Willebrand Syndrome (aVWS)🩸

A short 🧵

1/14 Intro:
-rare but underestimated bleeding disorder
-lab and clinic similar to inherited form
-usually occurs more frequently in adults with no history of bleeding
-renewed interest
👉association with 🫀disorders (eg aortic stenosis), cancer, autoimmune disease...
2/14

😱Gastrointestinal (GI) manifestations in hematology😱

A short visual 🧵with diagnosis

1/19 Intro:
-lympho-/myeloproliferative disorders
-nodal and/or extranodal
-GI tract one of the most common extranodal sites
-diagnosis of GI hematologic malignancy challenging
👉esp in absence of documented nodal/extranodal disease
👉due to higher incidence of other pathologies
2/19

😱Challenges in hematology😱

Richter transformation (RT)

A short 🧵#MedTwitter #MedX

1/20 History part I:
-1928, Maurice Richter reported generalized swelling of lymph nodes, liver + spleen in a patient with chronic lymphocytic leukemia (CLL)
-due to infiltration by rapidly growing cells
👉termed it generalized reticular cell sarcoma
-patient died after 22 days
2/20

When I started med school, I subscribed to the New England Journal of Medicine. Apart from published trials, case records are the world's treasure for education & help navigate clinical courses & differentials better than any class.

A visual 🧵of selected cases #MedTwitter #MedX 50-year-old man with back pain, fatigue, weight loss, and knee swelling

Final diagnosis: Ankylosing spondylitis
-affects 0.5% of population
-strongly associated with HLA-B27 allele
-90% of patients with ankylosing spondylitis are positive for HLA-B27
nejm.org/doi/full/10.10…

😱Complications in hematology😱

Hemorrhagic cystitis (HC)

A short 🧵 #MedTwitter #MedX

1/18 Short intro:
-sterile cystitis characterized by relevant hematuria
-most common after ifosfamide and high-dose cyclophosphamide in bone and soft tissue sarcoma and BMT
-viral
-or as a late toxicity of pelvic radiation therapy
2/18

Eye manifestations in hematology

A visual 🧵with diagnosis #MedTwitter #MedX

1/23 Short eye anatomy

2/23

Skin manifestations in hematology

A visual 🧵 with diagnosis
#MedTwitter #MedX

1/24 Koilonychia

Anemia due to nutrient deficiency
-eg iron, folate, vitamin B12
-other signs:
--pallor of the conjunctiva and palmar creases
--glossitis
--pruritus
--poikilodermatous hypopigmentation
--hyperpigmentation may be a sign of B12 and folate deficiencies
2/24

😱Challenges in hematology😱

Invasive aspergillosis

A short 🧵 #MedTwitter
1/18 Aspergillosis:
-refers to illness due to allergy, airway or lung invasion, cutaneous infection, or extrapulmonary dissemination caused by
--Aspergillus fumigatus (most commonly, ~2/3 of infections)
--A. flavus (~15%), A. niger (~10%), and A. terreus (~7%)
2/18

🧐Spotter in hematology🧐

A short 🧵 with some snapshots and diagnosis

#MedTwitter

1/13 Osteolysis in multiple myeloma

-myeloma activity sometimes appears as "lytic lesions" (with local disappearance of normal bone due to resorption) or as "punched-out lesions" on the skull X-ray ("raindrop skull")
-lesions may also be sclerotic, which is seen as radiodense
2/13

10 rules for life on how to deal with toxicity by seniors and colleagues.

A guide for trainees' well-being and humanity.

1/12 Intro:
Being a trainee in a toxic work environment can be incredibly challenging. Toxicity can hinder growth and well-being. It is often soft and hidden.
One of the meanest instruments of toxic people is ignorance against yourself while putting on a happy face in public.
2/12

🩸Smears in hematology🩸

A short 🧵 with spapshots and diagnosis

#MedTwitter

1/21 Short intro to hematopoiesis:
-formation of blood cellular components
-long served as paradigm of stem cell biology
-genomics introduced powerful new methods for investigating the hematopoietic system -hematopoiesis may be continuous rather than discrete/punctuated process
2/

Many of us love medicine because it is a visual discipline.

A short 🧵with snapshots on tongue changes #MedTwitter

1/ Short anatomy of the 👅:
-unique organ in oral cavity
-not only facilitates perception of gustatory stimuli but also plays important roles in mastication and deglutition
-integral component of speech
AND THUS
-human interaction and love
👉bad looks may impose social shame
2/

😱Complications in hematology😱

Human herpes virus 6 (HHV-6) infection

A short🧵 #MedTwitter

1/19 HHV-6 intro I:
-large double-stranded DNA virus in the β herpesvirus family that primarily targets CD4+ T lymphocytes
-other: monocytes, macrophages, epithelial + fibroblastic cells, hepatocytes
-BUT ALSO: astrocytes, oligodendrocytes, neurons👉important for later🧠❗️
2/19

10 rules for life of a young doctor.

How to deal with death and suffering.

A short 🧵

#MedTwitter #1 Embrace empathy.

Understand that every patient is unique and has a story worth hearing.

Listen.

Connect with your patient on a deeper level than just a "health provider".

Provide comfort and support.

It's necessary to reflect upon their pain.

😱Emergencies in hematology😱

Hyperleukocytosis and leukostasis

A short 🧵 #MedTwitter

1/12 Intro:
-Hyperleukocytosis (HLC) often defined as WBC of 100×10^9/L or more
BUT
-symptoms of leukostasis (LS) can occur at lower counts
-HLC👉microvascular obstruction👉tissue hypoxia+ infarction👉LS
-most common in acute leukemia, esp AML (5%-20%)
-children>adults
2/12

😱Emergencies in hematology😱

Hypercalcemia of malignancy (HoM)

A short 🧵 #MedTwitter

1/17 What causes hypercalcemia?
Before you think malignancies, think Chimpanzees:
Calcium supplementation
HCT
Iatrogenic
Myeloma, milk-alkali syndrome, medics
Parathyroid hyperplasia/adenoma
Alcohol
Neoplasm
Zollinger Ellison
Excessive vitamin D
Excessive vitamin A
Sarcoidosis
2/17

😱Emergencies in hematology😱

Malignant spinal cord compression (MSCC)

A short 🧵 #MedTwitter

1/11 Intro:
-true oncological emergency❗️
-up to 6% of cancer patients
-annual incidence of hospitalizations secondary to MSCC among patients with advanced cancer ~3.5%
-multiple myeloma and non-Hodgkin lymphoma with highest cancer-specific incidence
-prognosis poor
2/11