Arjun Arya, MD, MSc. Profile picture
attendant of EM | hey, hi, hello | forged in the flames @HennepinHC | #FOAMed | equity | leadership | dad jokes | always a work in progress
May 4, 2020 15 tweets 6 min read
Alright #MedTwitter & #MedStudentTwitter, I’m going to interrupt your regularly scheduled #COVID19 programming to talk about Blood Pressure, Shock & Using the Force (#MayTheFourthBeWithYou) to assess it! So,

Where would a measured blood pressure be highest?

1/
Blood Pressure (BP) in the body behaves as a hydraulic system and undergoes a process known as “systolic amplification.”

When two ocean waves run into each other, the resulting wave is a smaller but taller spike!

2/
Feb 28, 2020 11 tweets 5 min read
Because #COVID19 / #coronavirus is so hot right now, here’s a little #tweetorial on

How To Emotionally Not Explode During Pandemic 2019 (and Survive!)

First question on everyone’s mind is basically “will I die?” & here is what we know so far.

1/
When nerds study this question, the CFR or the Case Fatality Rate becomes THE tool. It’s the best early measure we have to predict the likelihood of death from exposure to #COVID2019.

What is the CFR for COVID19? About 2.3%.

Others -
SARS : 9.6%
MERS: 34.4%
Flu: 0.5%

2/
Jan 26, 2020 20 tweets 9 min read
Alright #medtwitter, #medstudenttwitter, & #CriticalCare, today’s #tweetorial is on the ever challenging and misinterpreted lactate!

So, what does lactate most appropriately represent?

1/
If you’re like me, you had lactate = anaerobic respiration = hypoxia drilled into your head.

First, is this real? And then, most importantly, is this clinically relevant?

To unravel this mystery-we need to know where lactate comes from!

2/
Dec 21, 2019 17 tweets 7 min read
#medtwitter #tweetorial on one of my favorite, elegant little mechanisms. This is something every #resident and #medstudenttwitter will see ALL the time! Bonus inclusion: a simple way to think about macro/micro-cytosis.

So, why is basically everyone in the hospital anemic?

1/
Principles:

- it is useful to remember that the venous blood “drawn” for a lab test is composed of many parts: plasma, RBCs and WBCs.

- Hemoglobin (Hgb) is a direct measure of the actual Hgb molecule within the RBCs

&

- hematocrit (Hct) is the % volume of RBCs

2/
Dec 16, 2019 28 tweets 12 min read
Alright #medTwitter and #medstudenttwitter, time for an Introduction to EKG #tweetorial 🙌🏽 full of GIFs, pearls & fun!

We are going to start off w/ some key principles and get all the way to the basics of a 12-lead #EKG!

1/28 First— just as YOU see an EKG, the EKG “sees” the heart! Only, since it’s paper and not smart, it needs many more “eyes” than you do.

Every EKG lead is an eye (electrode) that is seeing the heart’s electricity from its own perspective.

These are the EKGs 12 eyes:

2/28
Dec 8, 2019 12 tweets 3 min read
#tweetorial time for SUPER FAST, no WINTER or (difficult) MATH evaluation of Anion-Gap Metabolic Acidosis:

THE METABOLIC SEESAW. YEE HAW.

1/12 The metabolic seesaw:

dBC dAG
———————🔺———————
(more BC)

dAG = delta Anion Gap
dBC = delta Bicarbonate.
Toward the Center = more bicarbonate

This will all make sense in a moment.

2/12