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 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.

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 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.

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 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

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 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).

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 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

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 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

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 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.

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)

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

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

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 🧵

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)

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.

1/Educational thread on thrombocytopenia. Not medical advice. Always open for feedback, suggestions or corrections!
#medtwitter #hematology #oncology #internalmedicine #benignhematology 2/Platelet count - Normal ranges (±2 SD)
By Phase microscopy
140,000 - 440,000/μL
By automated analysers
177,000 - 406,000/μL

Platelet count < Lower limit of normal = Thrombocytopenia
Platelet count > Upper limit of normal = Thrombocytosis

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