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1/17 When should I send an ammonia? A thread 🧵 and list of indications #MedTwitter #TipsForNewDocs

Charlie M. Wray, DO, MS asks, and he receives (2 years later)! He asked for a 1-pager to help residents present effective chalk talks. With the help of the inimitable Gurpreet Dhaliwal & Academic Medicine, I present to you our humble attempt to fulfill his ask. Find it👇 bit.ly/3vaC5Dp

1/4: 🚨 “Do you think it’s ok to give this patient zofran? What about their QTc?” 🚨 #Tweetorial on QT prolonging drugs and torsades de pointes (TdP) 🧵 #MedEd #MedTwitter

#livertwitter ALT Bili INR Normal X X X Alc hep XX XXX X-XX Severe injury XXX X-XXX X-XX ALF XXX XXX >1.5 + HE

🙋‍♂️ Best bedside #POCUS & Echo summary I have seen! #MedEd #MedTwitter #FOAMcc Thanks to Cathy Cichon for this amazing medical art!

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?

You are seeing a patient with irresistible urge to move legs. How do you go from history to diagnosis? The diagnostic process involves: 1. Patient representation 2. Diagnostic framework 3. Differential diagnosis 4. Illness scripts

Nice review of SGLT2i’s

A 59-year-old woman 👉 had undergone transplantation of the left kidney 16 years earlier for the treatment of polycystic kidney disease

1/3 Hb or Hct? I prefer using Hb in patients with anemia because oxygen carrying capacity is limiting, and Hct in patients with polycythemia because blood viscosity is limiting. For those at equipoise, it's dealer's choice, though I like to think positively and use Hb. 😉

1/9 Hematologists are comfortable diagnosing and treating Fe deficiency. However, many of us are outside our comfort zone when it comes to chronic kidney disease. Why? Because the diagnostic criteria and indications for treatment are so vastly different, even antithetical.

Great framework for rounding

1/THREAD Ever wonder why fluoroquinolones increase the risk of tendon rupture? It seems so random that a whole class of antibiotics could cause tendon injuries, but the risk is real. #medtwitter #tweetorial

1/10 CASE 76 yo M with Waldenstrom's macroglobulinemia (WM; IgM 3000-5000 mg/dL), treated in past with rituximab, dexamethasone and cytoxan, presents with iron deficiency anemia. Colonoscopy and OGD negative. Capsule study shows multiple jejunal AVMs. Ring any bells?

I have grown to ❤️IV iron This is a nice review on the when, why and the how to fill the iron tank Josephine Cool Jason Freed doi.org/10.1002/jhm.13…

Why use hydrocort over dex in septic shock? When to prophylax (and for what?) When to stop steroids (and how?) I had a lot of ??? around steroids which led to this CORE IM episode, which really was a huge team effort given steroids = used for everything

Can never review this topic enough - “the water of life” as one of my mentors called 0.9 NS. Fluid choice usually engenders strong opinions, some of my favorite discussions. I’ve always been an #LR guy for general use. Source: CORE IM #MedTwitter

Just published online first & presented #IDWeek2023 Cefepime vs Piperacillin-Tazobactam in Adults Hospitalized With Acute Infection: The ACORN Randomized Clinical Trial Edward Qian Todd Rice & colleagues jamanetwork.com/journals/jama/…