Aaron Goodman - “Papa Heme” @AaronGoodman33 Twitter profile

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Aaron Goodman - “Papa Heme”

3 years

Cefepime = ceftriaxone + pseudomonas coverage Zosyn (pip/tazo) = cefepime + anaerobic coverage Meropenem = Zosyn + ESBL coverage Ertapenem = Meropenem - pseudomonas coverage Thank you for coming to my TED talk.

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

The only classical medical textbook I read cover to cover.

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

Learning Anticoagulants is Easy (kind of) Drugs target Xa = Xa in name ApiXaban BetriXaban EdoXaban RivaroXaban Drugs target BOTH Xa+thrombin = PARIN (pair) in name HeParin EnoXaParin DalteParin Drugs target only IIa = B (2nd letter) ArgatroBan Bivalrudin DaBigatran

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

1 year

Seeing patients with advanced cancer on carb restricted/salt restricted/low fat diets in the hospital makes me sad.

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

10 months

In honor of the new interns who will be managing a lot of electrolytes and fluids I am re-reading this gem.

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

A kiss that breaks the heart...

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

1 year

A kiss that breaks your heart. Happy Valentines Day!

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

Orange colored tonsils! Neuropathy Hepatosplenomegaly Corneal clouding Anyone care to offer a diagnosis?

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

10 months

Life as an oncologist In 1 day Tell a patient they relapsed after 5 years of remission Next room, celebrate scans with remission! Next room, transition long term patient/friend to hospice. Then go home eat dinner with family and ask kids how school was.

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

"Doc my right eye is droopy"

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

6 months

I don’t know who Dr. Sabatine is but he knows how to write a damn good concise book.

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

Tweetorial - How to learn an antibiotic! I learn following about every abx Does it cover 1. MSSA 2. MRSA 3. Enterococcus 4. Pseudomonas 5. Anaerobes 6. Scary gram negatives (ESBL) 7. Unique coverage (ampicillin = listeria) 8. Unique toxicity (imipenem = seizure)

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

11 months

CD markers simplified! CD34+ = Blast CD3+ = T-cell CD19+ = B-cell CD33+ = Myeloid CD34+ = Acute leukemia (but which type?) CD34+ CD19+ = B-ALL CD34+ CD3+ = T-ALL CD34+ CD33+ = AML CD34- CD33+ = APL (promyelocyte differentiated one step above blast)

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

This one takes me back to med school! Diagnosis?

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

"Doc I have trouble swallowing and my hands change colors" A nice constellation of symptoms with the perfect acronym. Diagnosis?

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

1 year

Current medical training system for experts 4 years of college 4 years of medical school (+4 yr for PhD for some) 3-7 years of residency 1-3 years of fellowship 1-3 years of sub fellowship End product = Physician who treats 1 disease at major medical center most can't access

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

1 year

It was a bad choice to swim in that delightful hot spring.

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

1 year

Don't forget to cook your pork or else...

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

1 year

Doctors suck at the physical exam for the most part yet are very skilled at documenting it.

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

How to learn an antibiotic! I learn following about every abx Does it cover 1. MSSA 2. MRSA 3. Enterococcus 4. Pseudomonas 5. Anaerobes 6. Scary gram negatives (ESBL) 7. Unique coverage (ampicillin = listeria) 8. Unique toxicity (imipenem = seizure) Example over next few days

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

11 months

A solid Reed Sternberg cell

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

Clusters of Differentiation 2 Tweets! Simplified! CD34+ = Blast CD3+ = T-cell CD19+ = B-cell CD33+ = Myeloid CD34+ = Acute leukemia CD34+ CD19+ = B-ALL CD34+ CD3+ = T-ALL CD34+ CD33+ = AML CD34- CD33+ = APL (promyelocyte differentiated one step above blast)

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

1 year

USMLE Step 1/2 Review for Med Students! Brief Tweetorial 5 Leukemias 5 Blood smears Be able to differentiate them 1. AML 2. ALL 3. CML 4. CLL 5. Adult T-cell leukemia/lymphoma

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

1 year

Ordering a medical test! Rule #1 If you have no idea what you will do with the result then don’t order it.

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

A kiss you will never forget, even 30 years later.

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

1 year

CD markers simplified CD34+ = Blast CD3+ = T-cell CD19+ = B-cell CD33+ = Myeloid CD34+ = Acute leukemia CD34+ CD19+ = B-ALL CD34+ CD3+ = T-ALL CD34+ CD33+ = AML CD34- CD33+ = APL (promyelocyte differentiated one step above blast)

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

Best medical textbook ever! ⁦ @Bloodman ⁩ and myself are going to try to make one even better!

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

5 months

All you need to know about ascites in one beautiful page!

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

A solid acronym! Diagnosis?

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

"Doc it hurts when I pee"

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

1 year

🍀Happy St. Patricks Day!🍀

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

1 year

Bad food = Bad infections A collection of infections for USMLE! Raw milk = Brucellosis Undercooked pork = Trichinellosis and Cysticercosis Left over rice = Bacillus cereus (toxin) Crab/cray fish = Paragonimiasis Raw meat = Clostridium perfringens Oysters = Vibrio vulnificus

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

1 year

I’m a doctor but I would be labeled a “difficult patient” if I am ever admitted to the hospital I would refuse Daily blood draws q4hr vital signs Bed alarms Colace/PPI Fluid restrictions Low fat diet I would destroy the beeping IV poll. Just give me the cefepime and let me be

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

1 year

How to learn an antibiotic! I learn following about every antibiotic I prescribe Does it cover 1. MSSA 2. MRSA 3. Enterococcus 4. Pseudomonas 5. Anaerobes 6. Scary gram negatives (ESBL) 7. Unique coverage (ampicillin = listeria) 8. Important toxicity (imipenem = seizure)

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

A blue eyed child...

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

You don't need a medical history for this one.

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

For Medical Students Learning Hematology! RBC morphology and etiologies courtesy of

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

If people want to play along with my quest to re-learn internal medicine this is the book I am using! I read a little bit every morning (like a page). Usually inspires a question for twitter and helps me learn better also. Honestly I am enjoying it.

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

Rule # 1 of ordering a medical test. If you have no idea what you will do with the result then don’t order it.

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

Hypercalcemia: A Tweetorial for Internist Calcium regulated to levels between 9-10.5 mg/dL ↑PTH = ↑calcium ↑Calcitonin = ↓calcium PTH produced by the chief cells in parathyroid glands Calcitonin produced by the parafollicular cells in thyroid

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

1 year

The GOATs

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

1 year

Coagulation is easy! 12,11,9,8 = Intrinsic = PTT 7 = Extrinsic = PT 10,5,2 = Common = PT/PTT 2,fibrin = TT ⬇️Vitamin K/Warfarin = ⬇️[2,7,9,10] =⬆️PT/PTT ⬇️Liver =⬇️5⬆️8 = ⬆️PT/PTT ⬇️13= Bleeding umbilical stump ⬇️12=⬆️PTT = No bleed ⬇️9 = Hemo B =⬆️PTT ⬇️8 = Hemo A =⬆️PTT

Aaron Goodman - “Papa Heme”

@AaronGoodman33

1 year

I have to teach the first year medical students tomorrow the coagulation cascade and von Willibrand disease. Thoughts and prayers appreciated.

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

1 year

In medicine I find it interesting that the more years you spend training the less diseases you end up knowing how to treat.

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

3 years

CD markers simplified CD34+ = Blast CD3+ = T-cell CD19+ = B-cell CD33+ = Myeloid CD34+ = Acute leukemia CD34+ CD19+ = B-ALL CD34+ CD3+ = T-ALL CD34+ CD33+ = AML CD34- CD33+ = APL (promyelocyte differentiated one step above blast)

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

8 months

It should be illegal for an “alternative medicine” doctor to tell a patient of mine to forgo “conventional” therapy for their life threatening malignancy and go “all natural”. Yet they can do this with no consequences.

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

6 months

CD Marker Mathematics CD34+ = Blast CD3+ = T-cell CD19+ = B-cell CD33+ = Myeloid Then do addition! CD34+ = Acute leukemia CD34+ CD19+ = B-ALL CD34+ CD3+ = T-ALL CD34+ CD33+ = AML CD34- CD33+ = APL (promyelocyte one step above blast) For more details

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

1 year

A very very bad kiss.

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

For the new interns - Anticoagulant Mechanism Name Jewels! Drugs target Xa = Xa in name ApiXaban BetriXaban EdoXaban RivaroXaban Drugs target BOTH Xa+thrombin = PARIN (pair) HeParin EnoXaParin DalteParin Drugs target only IIa = B (2nd letter) ArgatroBan Bivalrudin DaBigatran

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

1 year

"Doc people tell me I look tired all the time..."

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

"My tongue does not fit in my mouth anymore" Diagnosis?

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

CD markers simplified per request! CD34+ = Blast CD3+ = T-cell CD19+ = B-cell CD33+ = Myeloid CD34+ = Acute leukemia CD34+ CD19+ = B-ALL CD34+ CD3+ = T-ALL CD34+ CD33+ = AML CD34- CD33+ = APL (promyelocyte differentiated one step above blast)

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

1 year

Gram Postive Bacteria Morphology 1 Tweet 7 Gram Positive Bugs Cocci = spherical Chain or cluster Chains: Streptococcus Enterococcus Cluster: Staphylococcus Bacilli = rods Spore forming: Clostridium Bacillus No spores: Corynebacterium Listeria

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

5 months

For specialist trying to keep their internal medicine skills sharp I highly recommend this book. I try to commit a few pages to memory most Sundays and it makes me look like a star on rounds. Good book

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

A reminder to all new parents! Remember not to feed honey to babies! Diagnosis?

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

Pathology all of med Twitter should know!

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

9 months

When ever I see a new patient in oncology clinic I try to remind myself right before opening the clinic room door that right now is likely one of the worst/scariest/anxiety provoking days of their life. Then I go in the room.

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

A classic triad in pictures!

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

"Doc I am having trouble climbing the stairs" Diagnosis?

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

9 months

Never start rounds without it.

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

1 year

Someone please get this patient an orange.

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

Oncology Clinic is Strange. In 1 day Tell a patient they relapsed years after remission Next room, celebrate scans with no cancer Finally transition a long term patient/friend to hospice Then go home, pretend as if nothing happened, eat dinner,and ask your kids how school was

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

Here they are! The essential medical school “textbooks” These were my favorites and I still occasionally reread them!

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

When ever I see a new patient in oncology clinic I try to remind myself right before opening the clinic room door that today is likely one of the worst if not worst day in their life. Then I go in the room.

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

A patient is referred to the hematology for splenomegaly and "funny" looking RBCs. On exam you find something interesting... Diagnosis?

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

10 months

How to get into medical school: 1. Straight As (orgo, physics,molecular bio etc…) 2. Do lots of research (preferably in lab) 3. Lengthy CV 4. Ace the MCAT 5. Spend lots of💰to do above 6. Be competitive! How to be a good doctor: 1. Listen to your patients and communicate well.

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

Hematology Gold! My malignant hematology cheat sheets were requested. Intended for medical students, residents, or anyone interested in malignant hematology. DM for word file Feel free to correct mistakes and edit

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

1 year

Gardening can be so dangerous.

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

10 months

I need to motivate my daughter in third grade to publish more instead of playing with her friends so she can get into medical school and residency. Any suggestions?

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

3 years

Anticoagulant Mechanism Name Jewels Drugs target Xa = Xa in name ApiXaban BetriXaban EdoXaban RivaroXaban Drugs target BOTH Xa+thrombin = PARIN (pair) in name HeParin EnoXaParin DalteParin Drugs target only IIa = B (2nd letter) ArgatroBan Bivalrudin DaBigatran

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

Discovery of ITP was Epic Dr William Harrington, a hematology fellow at WashU, injected blood from an ITP pt into himself His plt count dropped immediately, and he was admitted to Barnes Hospital with epistaxis, gingival, rectal bleeding 1 week later his plt returned to normal

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

Antibiotics that cover pseudomonas!!! Cefepime Ceftazidime Pip tazo Ticracillin clav Meropenem Imipenem Doripenem Aztreonam Ciprofloxaxin Aminoglycosides NOT Ertapenem Ceftaroline Moxiflixacin

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

1 year

Before you tell someone they have “long COVID” please make sure they don’t have lymphoma.

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

1 year

My Favorite Medical Mnemonic of All Time! Feel free to share yours Causes of Pancreatitis I GET SMASHED Idiopathic Gallstones Ethanol Trauma (steering wheel) Steroids Mumps/Malignancy Autoimmune Scorpion sting (from Trinidad!) Hypertrygliceridemia/Hypercalcemia ERCP Drugs

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

🍀Happy St. Patricks Day!🍀

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

1 year

Talk like a pathologist Echinocyte = even spaced projection Acanthocyte = irregular spaced spike Schistocyte = fragmented Spherocyte = round no pallor Codocyte = target cell Drepanocyte = sickle cell Elliptocyte = cigar shaped Dacrocyte = teardrop Stomatocyte = slite area pallor

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

This person likes eating lots of pasta. Diagnosis?

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

"Doc my back pain is worse when I sit still but improves with movement. Also my eyes hurt." Diagnosis?

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

"My eyelids are heavy! It is worst at the end of the day!" Diagnosis? Diagnostic test of choice? Pathogenesis? Treatment of this case?

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

"Diarrhea" Diagnosis?

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

A patient presents to the ER with Massive hemoptysis

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

"Doc my back pain is worse when I sit still but improves with movement. Also my eyes hurt." Diagnosis? Huge bonus points and respect if you can name the rock guitarist who has this illness!!!

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

"Doc it is getting harder for me to walk up stairs"

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

Why doctors run late in clinic! 1. Clinic overbooked. This allows patient care to not be delayed weeks to months. 2. They spend more time with patient then time slot given (can’t tell someone they have cancer and then say bye in 10 minutes) 3. Prior patients showed up late.

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

"Doc it hurts when I pee and see and so does my knee!"

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

1 year

Good morning time to brush your teeth with some...

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

1 year

Massive Blood Transfusion Complications! ⬆️PT/PTT = pRBC contain no coagulation factors ⬇️Platelet = pRBC contain no plt ⬇️Ca = Citrate in pRBC binds Ca ⬆️K = K leaks out of cells in stored RBCs ⬇️Temp (hypothermia) = RBC stored at 4°C ⬆️Ph from metabolism of citrate in pRBC.

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

Owls Eyes

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

A very bad sore throat.

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

1 year

Coag tattoo on my back 12,11,9,8 = Intrinsic = PTT 7 = Extrinisic = PT 10,5,2 = Common = PT/PTT 2,fibrino = TT ⬇️2,7,9,10,(C,S) =⬇️Vitamin K/Warfarin=⬆️PT/PTT ⬇️5⬆️8 = Liver dz = ⬆️PT/PTT ⬇️13= Bleeding umbilical stump ⬇️12=⬆️PTT = No bleed ⬇️9= Hemo B =⬆️PTT ⬇️8= Hemo A =⬆️PTT

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

Quick list of antibiotics that cover anaerobes: Learn it! Clindamycin Metronidazole Ampicillin-sulbactam Amox-clavulanate Piperacillin-tazobactam Ticarcillin-clavulanate Meropenem Ertapenem Doripenem Imipenem Chloramphenicol Tigecycline

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

1 year

Diagnosis?

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

"Doc I have always been tall and skinny for my age and now I have pretty bad chest pain..."

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

Complications of Massive Blood Transfusion ⬆️PT/PTT = pRBC contain no coagulation factors ⬇️Platelet = pRBC contain no plt ⬇️Ca = Citrate in pRBC binds Ca ⬆️K = K leaks out of cells in stored RBCs ⬇️Temp (hypothermia) = RBC stored at 4°C ⬆️Ph from metabolism of citrate in pRBC.

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

Look at those beautiful eyes! Med students, I would expect you to know the diagnosis. Hematologists, I would expect you to know why this cell is so good at evading the immune system. Pathologists, I expect you to know everything

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

"Doc I am so itchy!" Diagnosis?

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

9 months

⁦ @shakira ⁩ we made our daughter a Shakira cake for her birthday and she’s delighted even though we’re trapped inside during a tropical storm/hurricane!

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

2 years

CD markers for leukemia simplified CD34+ = Blast CD3+ = T-cell CD19+ = B-cell CD33+ = Myeloid CD34+ = Acute leukemia CD34+ CD19+ = B-ALL CD34+ CD3+ = T-ALL CD34+ CD33+ = AML CD34- CD33+ = APL (promyelocyte differentiated one step above blast) CD34- = Mature CD34-CD19+ = CLL

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Aaron Goodman - “Papa Heme”

@AaronGoodman33

1 year

“The skin is the largest organ in the body” The start of every dermatology lecture ever in medical school.

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