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#mRNAvaccines for #PancreaticCancer (PDAC) PART4 1. Out today in nature nature.com/articles/s4158… 🧵👇🏽 [1/23]

This is incredible. (Also I did residency at the same time/hospital as this wonderful doc)

Proud of prominent Maryland ACP members Drs. Ravitej KhunKhun and Lucia Ponor for winning awards for voluntary faculty teaching and educational innovations, respectively, today at the Johns Hopkins IEE. Ravi Singh

I was devastated to hear of the passing of Ralph Schiavone today - an incredible man who was very special to me and innumerable others in #Toronto . He was my barber for 25 years and an important part of my life. I wanted to speak a bit about our special relationship.

#TipsForNewDocs Pt learns of mass on chest CT when the nurse tells her she's NPO for biopsy. Primary team assumed consult team told pt. Consult team assumed primary team told pt. Lesson: don’t assume. Include “tell the patient” as part of the plan. #kittlesonrules

Pickle juice for muscle cramps is back in the news because of Carlos Alcaraz winning Roland Garros For anyone interested in knowing why this works and the evidence for it, you can find it in these articles Review: pmc.ncbi.nlm.nih.gov/articles/PMC10… Clinical trial: pmc.ncbi.nlm.nih.gov/articles/PMC11…

(1/x) Septic shock is the leading cause of death in most ICUs worldwide. Unfortunately, the hemodynamics of sepsis are still often taught incorrectly in medical school. A 🧵

🧵 "What really determines tissue perfusion?" – and why most explanations get it wrong. Let’s sort out MAP, CVP, CCP, autoregulation, vasopressors, and the flow that actually reaches your organs. 👇

Renal case challenge! 💢 Here is the metabolic profile of an elderly human who presented for AKI. Why is the potassium being stubborn despite the urine output picking up with isotonic fluid resuscitation?

Terrific editorial by Mezzacappa and Lupe GGT 1. Antibiotic prophylaxis in cirrhosis with UGIB should be examined carefully 2. A meta-analysis of old and unrepresentative studies sadly cannot answer any questions

Another amazing case presented on an A&A episode of The Clinical Problem Solvers with the masters of clinical reasoning, Austin Rezigh & Alec Rezigh! Submit your case and present it at our Virtual Morning Reports! Check my cases on CPSolvers: docs.google.com/document/d/1cX… youtube.com/watch?v=iTbdLM…

Join us for another Guestpisode featuring the amazing Austin Rezigh! An unforgettable case with some unforgettable takeaways... Thank you, Austin!

POCUS Troubleshooting 101 🏆 Ever put the probe on a patient only to be totally disappointed in what you see (or don't see) on your screen? 🩻🤦‍♀️ Learning #POCUS can be frustrating, especially if things seem to go wrong from the get-go. But sometimes the solution is

A week on the teaching service BIDMC IM Residency 🏥 1. Sometimes a CXR speaks a thousand words ... Below is the CXR of a patient with no peripheral edema but who presented in respiratory extremis ...

One picture, enough said. This is why 👨‍⚕️👩‍⚕️ "feelings" about congestion don’t cut it. #POCUS #Nephpearls #VExUS #FOAMed

🧵 The Cardiac Function Curve — why it misleads (Part 1) 1/ The cardiac function curve is one of the most recognisable images in physiology. Unfortunately, it’s also one of the most misdrawn, mislabelled, and misunderstood. Let’s redraw it — and see what it really tells us about

🧵 Part 2 — The Venous Return Curve 1️⃣ Last time, we fixed the cardiac function curve. Now let’s look at the other half of the story — venous return — and how the circulation really feeds the heart. #FOAMed #MedX #physiology

Octreotide pearls 1. When a patient comes in with upper GI bleeding, you do NOT need a PPI with octreotide because “it may be an ulcer”. Both drugs raise the gastric pH to the same amount 2. Octreotide stops working after 3-6 days.

Ammonia is open to work

Ascites management