Nishant Rajendra Tiwari Profile picture
HemOnc Fellow @OUHealth @StephensonCC. Small town boy in a big arcade 🌃 Shayari = Hobby ❤️ Tweets are not medical advice. Views are my own.
Jan 16 25 tweets 4 min read
Educational 🧵 on “clinical pearls in conventional chemotherapy.” Not medical advice. Always open for feedback and corrections. Information packed thread, please bear with me. These are basics, many nuances to these.
#oncology #hematology #MedTwitter #OncTwitter #bmtsm Image 1/Methotrexate(MTX)
*MTX accumulates and exists slowly from third space fluid collections such as pleural effusions. Such fluid collections should be drained before giving MTX therapy.
*MTX and its metabolites precipitate in acidic urine, urine alkalinization should be done.
Jan 6 24 tweets 5 min read
Educational 🧵 on hemophagocytic lymphohistiocytosis (HLH). Not medical advice. Always open for feedback and corrections. Inspired by and studied from the recent review from @ASH_hematology hematology education series 2023 edition.

#MedX #Hematology #HLH #MAS #Lymphoma #oncology Image 1/HLH is a life threatening hematological emergency characterized by aberrant inflammatory response, with excessive and inappropriate T-cell activation. It poses a diagnostic challenge due to it's overlap with many infectious and systemic diseases.
Oct 11, 2023 18 tweets 3 min read
Educational thread on complications of blood transfusion. Not medical advice. Open to feedback and corrections! The incidence rates are as reported in the USA.
#MedX #Hematology #Transfusion #Bloodbank #InternalMedicine #MedEd Image 1/Acute hemolytic transfusion reaction
-Due to ABO incompatibility
-Incidence: 1:110000 transfusions
-70% of cases due to RBCs and 30% due to platelet transfusion
-50% of ABO-incompatible RBC transfusions are inconsequential, and 5% are fatal
-Positive Direct antiglobulin test
Aug 25, 2023 24 tweets 6 min read
Educational 🧵 on a topic very close to my heart - thrombotic thrombocytopenic purpura (TTP). Not medical advice. Always open to feedback and corrections. #MedX #Hematology #BenignHematology #TMA #TTP #MedTwitter #InternalMedicine #Match2024 Image 1/TTP
TTP is characterized by peripheral blood smear showing schistocytes, thrombocytopenia, laboratory evidence for intravascular hemolysis, end-organ damage, severe deficiency of ADAMTS13 (<10%)(A disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13).
Aug 20, 2023 17 tweets 2 min read
Educational 🧵 on cytogenetics in common hematological malignancies. Not medical advice. Always open to feedback and corrections. From classical literature, some recent advances might be missed.
#medX #internalmedicine #hematology #oncology #myeloma #leukemia #lymphoma Image 1/Cytogenetics
-Human cytogenetics is the study of chromosomes, their structure, and their inheritance
-Human genome of a healthy person contains approximately 23000 genes and contains 46 chromosomes
-Chromosomal disorders are classified as structural or numeric alterations
Jul 30, 2023 25 tweets 5 min read
Educational 🧵 on chronic myelogenous leukemia (CML). Not medical advice. I am a big fan of Dr. Druker, Dr. Cortes (@GCC_Cortes), Dr. Radich, and multiple others for their work in CML. Always open for feedback and corrections. #Medtwitter #hematology #leukemia #CML Image 1/CML
-Clonal myeloproliferative neoplasm characterized by expansion of myeloid cells in the bone marrow
-Rare, 10-15% of all leukemias
-Slight male predominance (1.5:1), ionizing radiation is the only known causative factor
-Incidence increases with age, rare cases in children
Jul 25, 2023 17 tweets 3 min read
A short educational 🧵 on the basics of inherited bone marrow failure syndromes (IBMFSs). Not medical advice. Always open to feedback and corrections. I am a big admirer of Dr. Patnaik’s work on this topic. @MrinalPatnaik
#MedTwitter #Hematology #Oncology #IntMed Image 1/IBMFSs are a group of disorders that manifest as ineffective hematopoiesis due to mutations causing failure of hematopoietic stem cell progenitors.
Most of them increase the risk for Aplastic anemia, MDS, Leukemias, a short account of the diseases is below.
May 16, 2023 29 tweets 4 min read
1/Educational thread (29 tweets) on Hodgkin Lymphoma (HL) basics. Not medical advice. Open for feedback and corrections. Dedicated to Dr. Collins @graham74GC . I learned a lot about Hodgkin since following him. #Medtwitter #Hematology #Oncology #InternalMedicine #lysm 2/HL-Epidemiology
-10% of all lymphoma cases
-Bimodal age distribution (Early 20s, Mid 70s)
-Slight male predominance (1.3:1)
Aug 29, 2022 6 tweets 2 min read
Educational 🧵 on basics of high penetrance hereditary breast cancer. Not medical advice. Always open to feedback and corrections.
#medtwitter #internalmedicine #oncology #breastcancer @AaronGoodman33 @Sthanu5 (Bosses of medical education on twitter) 10/PALB2
*Hereditary pancreatic cancer
‘Pancreatic cancer, female breast cancer and male breast cancer risk increased
‘Annual breast MRI and mammogram starting age 30 in women
Aug 18, 2022 25 tweets 4 min read
Educational 🧵 on von Willebrand factor (VWF), congenital von Willebrand’s disease (VWD). Not medical advice. Always open for corrections and feedback. Common abnormalities are described and is not a comprehensive account. #medtwitter #hematology #Classicalhematology 1/VWF - basics
*Multimeric glycoprotein
*Two key functions:
Primary hemostasis– attaches to exposed collagen, platelet adhesion, and platelet aggregation (Principal functions)
Secondary hemostasis– Binds to Factor VIII, and prevents its proteolysis, hence prolonging its half-life
Aug 15, 2022 26 tweets 5 min read
Educational 🧵 on autoimmune hemolytic anemias (AIHA). Not medical advice. Always open to feedback and corrections.
#medtwitter #hematology #internalmedicine #classicalhematology 1/Immune hemolytic anemia
Broadly divided into three groups:
Autoimmune hemolytic anemia (AIHA)
Alloimmune hemolytic anemia
Drug induced immune hemolytic anemia
We will discuss AIHA in this 🧵
Aug 3, 2022 9 tweets 2 min read
1/Educational thread on basics of NENs(Neuroendocrine neoplasias). Not medical advice. Inspired by the NEN bossman(Dr. Lewis)- @marklewismd. Always open to corrections, and feedback. Mostly based on classic literature, and recent advances are not included. #MedTwitter #oncology 2/NENs
-Neuro:Presence of dense core granules (DCGs)
-Endocrine:Synthesis and secretions of monoamines
-Broadly divided into:
Neuroendocrine tumors: Well differentiated (NETs-Low grade)
Neuroendocrine carcinomas: Poorly differentiated (NECs-High grade)
Jul 2, 2022 23 tweets 4 min read
1/Educational thread on PNH. Not medical advice. Rookie attempt to imitate @AaronGoodman33 and @nihardesai7 sir for what they do on twitter for hematology education. Long thread, but I think, worth a glance.
#medtwitter #hematology #IM 2/PNH defect.
Severe deficiency or absence of Glycophosphotidylinositol (GPI)-anchored proteins, specifically, CD55 and CD59.
Normally,
CD55 functions to destruct C3 convertase.
CD59 functions to regulate MAC.
Apr 12, 2022 25 tweets 4 min read
1/Educational thread on Pneumocystis pneumonia, not medical advice. Long thread, but might be useful for many!
Open to feedback and corrections 😃 2/
Organism -
Pneumocystis jiroveci
History -
- First detected in some premature infants in Europe at the time of the World War-2
- Rapid increase in incidence in the 1980s due to HIV epidemic
- Last two decades 2000-2020, more marked increase in renal transplant patients