A glimpse into internal medicine residency at MGH! #MedEd #MedTwitter
Resident Run Account
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Apr 8, 2021 • 7 tweets • 4 min read
1/ 34 y/o F with new AML dx on chemo (7+3) ANC 200. Counts are expected to continue to drop & not get better for at least another ~10d. Has been febrile 🌡️🔥 & on cefepime 2g q8 for the past 5 days💊💉. What do you do next?
Neutropenia: ANC ≤ 500 or an expected 📉 to an ANC of ≤ 500 in 48h
Mar 17, 2021 • 8 tweets • 4 min read
1/36 y/o F hx of anxiety p/w a 2nd episode of transient chest pain w emotional stress & her admission EKG shows 4 mm ST elevations in leads V1-V3. Her 1st troponins check was high. She is currently chest-pain free & vitals are normal.
What do you do next? #MedTwitter2/ This is a picture of her EKG
Feb 9, 2021 • 4 tweets • 3 min read
1/ID docs are known for their smarts, amazing notes and for being.....NOSY! 👃🔍
Former chief resident & ID fellow @PierreAnkomah unravels the clinical reasoning behind
Recap of noon conference today with Dr. Nancy Wei on every intern’s favorite call admission aka DKA!!
Here’s a framework to think about the different types of ketosis-prone diabetes subgroups!
Remember to think about beta-cell function and auto-antibody status to beta-cells!
Aug 25, 2020 • 5 tweets • 1 min read
Lets kick it with Dr. Bill Kormos and try not to pass out with excitement as we talk syncope
4 questions to ask: 1) Did this person have a LOC 2) Was it from syncope or non-syncope (rule out mimics such as metabolic, seizure, pseudo-syncope etc.) 3) Is the etiology of syncope clear (consider meds) 4) What is the underlying risk of cardiac syncope
Aug 25, 2020 • 5 tweets • 1 min read
Welcome to VTE Pearls with Dr. Sasha Wong 🫁
Think Virchow's triad for risk factors for hypercoagulability: stasis, endothelial injury and hypercoagulable state
Plane rides are not high risk in a healthy patient ✈️
Aug 21, 2020 • 8 tweets • 2 min read
Take a DEEP breath for part 2 🫁 of gas exchange with the great @galbamd1/ Recap from Yesterday:
The partial pressure of O2 has a sinusoidal relationship with
the oxygen content.
The partial pressure of CO2 on the other hand has a a much more linear relationship due its ability to dissolve better
Aug 20, 2020 • 7 tweets • 2 min read
get pumped 👊 for more pulm #twearls from @galbamd tomorrow, but here's what we learned after part 1 of gas exchange today...
1/ 72yoM with COPD (FEV1 0.5L ~25% predicted) is admitted with a COPD exacerbation with accessory muscle use, RR 33, SpO2 84% and ABG 7.3/80/55. He is placed on NRB with improvement in SpO2 to 100%. He becomes obtunded and repeat ABG is 7.1/110/50. Why?
Jul 16, 2020 • 13 tweets • 5 min read
1/ @HawraAllawati (senior resident) here! Current fellow/MGH res alum @the_tjroberts & I found ourselves checking off an infamous task at 2 AM
[x]swing special slide🔬🩸
This inspired the following 🧵! Follow along & we guarantee that you will have a BLAST 😉! #MedTwitter2/
63 M presents w CC of SOB x3 weeks. ROS: easy bruising.
You pause and astutely start worrying about... acute leukemia!
What now?!
Jul 1, 2020 • 5 tweets • 2 min read
#FirstTweet! We will be sharing hepatology #Twearls from this morning's res report led by GI fellow extraordinaire @JacquelineChuMD!
2/5💡"Not all cirrhotics are created equal"-> It's important to distinguish compensated from decompensated cirrhosis! The latter indicates a much worse prognosis.
Some hallmarks of decompensated cirrhosis:
▪️ascites
▪️hepatic encephalopathy
▪️variceal bleed.
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