1/5
Having finally assembled an amazing team,
@MedTweetorials
is now hoping to work towards systematically collecting and cataloging
#MedEd
#Tweetorials
.
What do you need to know?
1/
Patients with iron deficiency anemia generally dislike taking oral iron (nausea, constipation) and often stop taking iron tablets.
Does the way we prescribe ferrous sulfate contribute to this?
Read on to find out.
1/THREAD
Why would adenosine, a purine nucleoside, be able to treat supraventricular tachycardias (SVT)?
And why are its effects so short lived (e.g. <2 seconds)?
The answers will change the way you think about this drug.
#tweetorial
#medtwitter
1/
There seems to be an association between the use of "normal" saline and acute kidney injury (when compared with other IV fluids).
Why would that be?
#medthread
#medtwitter
#tweetorial
1/26
Which beverage is best for your liver?
a. Coffee
b. Tea
c. Green tea
d. Green juice detox
e. Green coffee
The answer of course in good old coffee, because...
...here is a thread on it
Spoiler alert: Its not just good for the liver
There is so much more.
If you have ever wanted to search our compilation of
#Medtweetorials
then click here and use the control F command to search.
We have over 700 logged. You can also search them by specialty and author. Enjoy!
@tony_breu
@inglisjosh
@iniya_rajendran
Stop KILLING Your Patients with Fluid! Learn how to avoid Fluid Overload with Venous Congestion Evaluation using
#POCUS
New BLOG POST on the
#VExUS
Protocol! Step By Step Guide, Downloadable PDF Pocket Guide, & Calculator
👉🔗
#medtweetorial
👇(1/10)
1/🧵
Ever wonder why severe hypertriglyceridemia causes acute pancreatitis?
Are triglycerides themselves toxic to the pancreas or is there something else going on?
#tweetorial
#medtwitter
1/🧵
Why does Wenckebach AV nodal block (aka Mobitz type 1) present with progressive prolongation of the PR interval and eventually a non-conducted P wave?
What causes this unique EKG pattern to arise?
#medtwitter
#tweetorial
1/14
How do diuretics lead to metabolic alkalosis?
I often invoke "contraction alkalosis", typically as a hand-wave explanation as patients' bicarbonate increases with diuresis.
Should I continue to wave my hands?
1/
Why can furosemide improve dyspnea/pulmonary edema from acute congestive heart failure within minutes of administration?
The answer does not involve diuresis.
#medtwitter
#tweetorial
Name the organ failing or missing just by looking at a blood smear. Hematologists don't need advanced imaging!
Tweetorial/Pictorial
1/5
First one to Tweet back all 4 answers wins
1/🧵
Did you know that heparin can cause hyperkalemia?
But why would an anticoagulant like heparin increase serum K⁺ levels?
The answer also has a wild implication - that heparin may itself have a diuretic effect...
#medtwitter
#tweetorial
1/🧵
Why is a ketogenic diet a potentially effective treatment for refractory epilepsy?
There's something almost magical about the idea that a specific type of diet could reduce the risk of epileptic seizures.
Let's explore why that might be.
#medtwitter
#tweetorial
هل تعرف إنك ممكن تتبرع بأكثر من نصف كبدك وتعيش حياة طبيعية بعدها
إيش يعني زراعة كبد ومين يحتاجها
وكلمة أدوية مثبطة للمناعة اللي بنسمعها في كل مكان في أيام #كورونا ماهي علاقتها بزراعة الكبد
هذا موضوع #ثريد الليلة
فضل التغريدة❤️
#livertwitter
1/15
Why are statins administered at night?
In this tweetorial I'll discuss the mechanistic and historical reasons for the frequently used QHS dosing schedule. And why it's often unnecessary.
But before we get there, I'm curious: when do you prescribe/order/take statins?
How often do you check for Primary Aldosteronism (PA)?
Chances are, NOT nearly often enough!
VA study reveals widespread undertesting...can we do better?
If you've seen 10 pt's with HTN ➡️ you've probably seen PA!
Let's review in this
#medtweetorial
#Tweetorial
(1/8)
Is it possible to offer a safe
#AMI
rule-out for low-risk patients with chest pain outside of hospital EDs?
OUT-ACS study from Norway validates
@escardio
#ESC
0/1-hour algorithm for hs-cTnT in a primary care emergency setting
This was my 8th case on
@CPSolvers
VMR 🙀 with some twists and riddles to
@jeff_sharman
,
@rachel_tenney
, and
@hraza222
Fortunately, I was faster than
@rabihmgeha
and turned off my mic first😄
A 25 y.o M w/ brown urine + altered lipid profile test -how can you link these 2?🤔
Picture this 📸
Your patient with Waldenstrom presents with a nosebleed and on exam 👇 you find her eyes like this.
What’s happening? 👀
A
#Tweetorial
🧵 1/5
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
1/
It was a delight to work with
@caseyalbin
to explore the incredibly diverse CNS complications of infective endocarditis!
An
#infographic
&
#tweetorial
investigating the radiographic & clinical findings in IE, with some management pearls.
#MedEd
#Neurotwitter
1/ “Visual representations are time-efficient and designed to engage the reader's visual processing capacity and decrease
#cognitive
workload.”
How do you start w/
#infographics
& visual abstracts?!
🧵 on Rip Out w/
@AylC1989
@AndrewMIbrahim
& Amy Ou !
1/THREAD
Have you ever wondered why Pseudomonas aeruginosa smells like grapes 🍇?
The answer relates to the ability of Pseudomonas to cause chronic airway infections and also coincidentally explains certain spoiled wine flavors.
#medtwitter
#tweetorial
1/13)
#MedTwitter
& has been an inspiring experience, however it can be 😳 at first
It was truly an honor to write this article in
#AmJGastro
alongside THE
@AmyOxentenkoMD
👉
Here is a brief
#Tweetorial
summarizing our paper, & some tips & tricks
This week we are recognizing the wonderful work done by our Infectious Disease colleagues as we feature
@IUIDfellowship
as our featured author and 2 great
#medtweetorials
by
@WuidQ
&
@MayoClinicINFD
If you don't follow them I suggest you start now
▶️▶️
1/
Pulmonary vasodilators are generally not used for patients with pulmonary hypertension due to COPD, even if severe.
Why would that be?
#medtwitter
#medthread
#tweetorial
Handout from our Endocrinology episode, "Episode 33: Hypercalcemia" with Dr. OP Hamnvik
@ohamnvik
is now out!
📝Download it free here:
🎶Episode:
check out👇for a
#tweetorial
on PTH-dependent & PTH-independent causes of hyperCa
A patient comes in for these skin findings. He says he’s getting darker everywhere. He’s frustrated because he moved to the countryside a few years ago to “get away from the stress of the city,” & now keeps getting headaches!
Diagnosis?
#dermtwitter
#medtwitter
#meded
#FOAMed
In need of a good podcast to go with your
#medtweetorial
addiction? Check out the
@CuriousClinPod
's new podcast, Why does metronidazole treat both bacterial and parasitic infections? The accompanied tweetorial by
@AvrahamCooperMD
1/15
Ever wonder why metronidazole (Flagyl) treats both bacteria and parasites?
The answer may also explain the infamous disulfiram-like reaction that can occur when metronidazole is mixed with alcohol.
#tweetorial
#medtwitter
1/
WHY is there a BABOON in my room?
A
#tweetorial
about the outcomes of hepatic coma, how far we have come, and how wild things got along the way
#livertwitter
#FERRITIN
is being widely ordered these days. Let's dive into the details and learn more about this protein. A short thread for those interested. Covers some history, biology and practical aspects about FERRITIN.
1/n
1 / What is Acute Kidney Injury?
🔶 Cr increase at least 1.5 times baseline OR
🔶 ≥ 0.3 mg/dl increase within 48 hours
(A Cr decrease of 0.3 cannot be used to diagnose AKI)
🔶 Urine volume < 0.5 ml/kg/h for 6 hrs🙄
That's easy. But what is baseline? THIS gets complicated...
How do we provide a prognosis of
#cirrhosis
?
A
#livertwitter
#tweetorial
Let's go deep to the very first prognostic tools
& see how everything old is new again.
Keywords: Child class, MELD, Frailty
1/18
🤔Why don't we use immunosuppression after bioprosthetic valve replacement?
Not only is the graft not self, but most aren't even from the same species and instead are from cows or pigs.
But unlike other transplants, we forego immunosuppression. Why?
Let's have a look.
1/14
🤔Why does it take weeks for the radiographic evidence of pneumonia to clear?
Patients often feel better DAYS after starting treatment.
And yet the chest x-ray takes WEEKS to return to normal.
Why the delay?
Spent yesterday reviewing some common coagulation 🩸labs and their interpretations.
Here is a graphic I made as a refresher🙂
Keep reading for a few additional points on PT and PTT. /1
1/ 🚨New Episode! 🚨
What is an “appropriate” Hgb bump?
Why do we usually say 1g/dL for 1 pRBC?
iTunes:
Show Notes:
First, let’s figure out how many grams of hemoglobin are donated?
A
#MedTwitter
🧵on the frequently obtained, but ever mysterious🕵️♀️ Procalcitonin (PCT) 🦠
💡 What is it?
💡 Where does it come from?
💡 What factors/comorbid conditions may impact PCT?
#IDTwitter
#TwitteRx
1/
#AGEP
(ACUTE GENERALIZED EXANTHEMATOUS PUSTULOSIS)!
A
#medtwitter
#dermtwitter
#tweetorial
!
#MedEd
#FOAMEd
This is a drug reaction that we can see on inpatients, with an exam full of pustules!
Let's start with a question - How long after drug exposure does AGEP appear?
💥 Tweetorial on ‘Cryoglobulinemia’
⚡️What are Cryoglobulins?
⚡️When should a clinician suspect Cryoglobulinemia & Cryoglobulinemia vasculitis?
⚡️How to establish the diagnosis?
⚡️Significance of Rheumatoid Factor
1/
@GlomCon
#Onconephrology
1/
There seems to be an association between the use of "normal" saline and acute kidney injury (when compared with other IV fluids).
Why would that be?
#medthread
#medtwitter
#tweetorial
Does Measuring Cardiac Output ❤️ with
#POCUS
seem confusing 😕? Let's Demystify that today 😀!
1⃣Measure LVOT Diameter
2⃣Measure LVOT VTI
3⃣Measure HR
4⃣Calculate SV and CO
5⃣FREE Pocket Guide PDF!
✅New Blog Post & PDF
🔗👉
#medtweetorial
👇(1/n)
Talking with
@reepRN
and
@nsivcd
about
#Takotsubo
cardiomyopathy made me go hunting for an old gif. Clearing out my hard drive so here is an old school gif firesale. Everything must go!
#CardioEd
1/6
Time for a
#tweetorial
!
In my medical training, I have seen several patients without cardiac history who have EKGs with prominent R waves in lead V1. Check out this 🧵for a differential diagnosis framework on categories and causes of large R waves in V1!
#meded
@CardioNerds
Young pt ➡️ 🏥 worsening shortness of breath
PMH: ESRD. Only 1 HD session/week. However, residual urine volume has now decreased substantially
On exam: BP 134/94, 2L O2,🧠✅, elevated JVP, decreased 🫁 sounds at bases, No murmurs, very mild edema. Functional left BC AVF
1/13
What's the deal with ... Gilbert's syndrome?
Unconjugated bilirubin deserves its own
#tweetorial
Featuring:
🟨Why?
🟨Is it bad or...PLOT TWIST...good!?
🟨What to do about it?
🏆The most 🍌🍌trials ever conducted
#livertwitter
#meded
#MedTwitter
1/
Handout from our newest COVID Conversations episode "ICU Management of COVID-19" is now out!
📝Download it free here:
🔊Episode:
Here's a brief
#tweetorial
on some of the ARDS management resources embedded within our handout:
🧵 BPH and the metabolic syndrome. What do waist size and urinating have to do with each other. So we often simplify the relationship between prostate enlargement and urinary symptoms in men. First, Its important to know all symptoms are not BPH.
1/🧵
Ever wonder why cutting onions makes you cry?
Something must be released that causes this irritating response, but what?
It turns out that cutting an onion jumpstarts multiple chemical reactions, in the air and right in front of your eyes.
#medtwitter
#tweetorial
🧅
ICU stories: Middle-aged pt w/o significant PMHx presented to the ED on a Friday afternoon w SOB/cough x 2 wks. Vaxed x2 but tested C19(+). BP 120/90, Sat 98% on 2 l/m. ECG: new-onset Afib/HR 140/QTc 500. CXR attached; read as RLL infiltrate. Labs: Na 125, BNP 800 (nl<100),
1/14
Why doesn't pneumonia (or other issues with gas diffusion) lead to increased pCO₂?
If one mechanism of hypoxemia in pneumonia is decreased diffusion of O₂ through fluid-filled alveoli, shouldn't CO₂ be similarly affected, leading to hypercapnia
Let's examine why not!
1/6
Can insulin drips be used for more than DKA?
45yo man w/ T2DM on insulin, HTN, h/o hypertriglyceridemia induced pancreatitis presents w/ constant severe epigastric pain x 1 day. TG levels >1500.
Why was an insulin drip started?
#medtwitter
#tweetorial
1/14
How does fever help us fight infections?
For millennia, fever has been recognized as a beneficial response to invading pathogens.
If this is so, why don't we have a resting temperature of 102°F (38.9°C)? Wouldn't that protect us even better?
Let's have a look.
The last few weeks have been tough. For those in need of a light hearted thread, here’s a brand new 3rd
#tweetorial
in my extremes of
#physiology
series. What can the animal kingdom teach us about our physiology?
Buckle up for some fun animal pulmonary facts 🫁!
1/
1/
A 48 yo 👩🦰 w/h/o SLE presents w/ asymmetric quadriparesis, incoordination & urinary retention. She was previously treated for SLE, but has been in remission for years.
She is severely weak in BLE R>L with hyperflexia
Is this a manifestation of SLE?
A
#ContinuumCase
Based on Run The List 📝 Episode 48, here goes nothing with a
#tweetorial
on lymphadenopathy (LAD)
Thanks to Kushal (
@k_vaishnani
) for this week's RTL edition!
1/15
Why is torsemide my preferred loop diuretic when treating heart failure?
As a follow-up to a recent tweetorial on furosemide and gut edema, let me offer a 3-part ode to torsemide.
1/🧵Fluids in sepsis: When a patient’s blood pressure is too low and they are in shock, as happens all the time with
#COVID19
viral
#sepsis
, we give fluids. This
@bmj_latest
figure👇makes a bit of sense of where the fluid goes. Let me unpack a bit more…
1/16
How does diabetes mellitus (DM) lead to an increased risk of infection?
I'll often hear this referenced on rounds or in morning report, but I don't recall having heard the mechanism.
As you might guess, there are many potential explanations; let's look at one of them...
🤔 Does metformin cause vitB12 deficiency?
❗️Metformin is the most prescribed drug for type 2 diabetes. Should you monitor vit B12 in pts taking it?
Follow the🧵
#MedTwitter
#tweetorial
#Endotip