André Martin Mansoor (@AndreMansoor )

André Martin Mansoor

Bio Clinician. Author of #FrameworksForInternalMedicine. Cofounder https://t.co/tknXc0rwOV. https://t.co/gRv9lQrnRk
Location Portland, OR
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Account created 05-10-2018 21:01:10
ID 1048317193933508609

Twitter Web App : Happy to give any/all of these 50-min talks to students, trainees, or anyone else anywhere, for free. DM me

1. Art and Science of the Jugular Venous Pulse: youtu.be/5iQ9mtomsvY
2. Art and Science of Diagnostic Reasoning: youtu.be/27dBgLbSvDQ
3. Physical Diagnosis Potpourri

Twitter Web App : Anticipation is key in medicine. The eyes can't see what the mind doesn't know. The ears can't hear what the mind doesn't know.

Thanks for reading.

If you liked this thread, visit pdxpdx.com for more.

Twitter Web App : A standardized test would provide all of these clues on a silver platter. Any machine can synthesize them and make the diagnosis. The clinician must not only synthesize, but gather these clues at the bedside. Your search must be hypothesis-driven or you might miss them.

Twitter Web App : This patient has scleroderma with systemic involvement (SSc). Typical cutaneous manifestations include telangiectasias, sclerodactyly (+ Prayer sign), and calcinosis cutis (nodule on her elbow). SSc can cause pulmonary hypertension, leading to Kussmaul's sign and loud P2.

Twitter Web App : Many medicine procedures involve (1) pushing a needle into a fluid-filled space, (2) advancing a plastic catheter over the needle into the space, (3) pulling the needle out, and (4) leaving the catheter in either for drainage or infusion.

Things often go wrong at (2).

1/5

Twitter Web App : 2/
Karel Frederik Wenckebach, a Dutch anatomist/physician, noticed a patient’s irregular pulse in 1898.

He astutely noted a repeating cycle of:
🫀 Progressive delay b/w the 𝑎 jugular venous wave and carotid pulsation
🫀 An 𝑎 wave w/o carotid pulsation

ncbi.nlm.nih.gov/pmc/articles/P…