Sam Altman on why you should work hard at the beginning of your career:

🧵 Neuro-Sjögren’s: Beyond Dryness Sjögren’s Syndrome isn’t just sicca. When nerves get involved, it can be devastating — and often misdiagnosed. Here’s a deep dive into neurological manifestations of Sjögren’s Syndrome👇 #Rheumatology #NeuroSjögren #MedTwitter

1️⃣2️⃣ Treatment Principles Depends on phenotype: ✔️ SFN / mild sensory – Gabapentinoids, duloxetine, IVIG (in select cases) ✔️ Mononeuritis multiplex / vasculitic neuropathy – Steroids + cyclophosphamide or rituximab ✔️ CNS involvement – High-dose steroids, immunosuppressants

🧵 CRP in Rheumatology – When It Lies, Lags, or Leads You Astray Because inflammation is complex—and so is CRP. Dr Ihab Suliman Dr. Akhil 🇮🇳 American College of Rheumatology #NEETPG #MedTwitter

🧵 Thread: “Steroid Unresponsive Arthritis? Don’t Miss This Mimic” A young woman with “seronegative arthritis” is on steroids for 3 months. Still flaring. No response. Rheumatoid? Nope. This was TB. Let’s break down the great mimics of inflammatory arthritis. 🧵 #Rheumatology

🧵 C3 vs C4 — What the Pattern Really Means (in 30 seconds) We order complements all the time. But the pattern is the diagnosis. Here’s the fast way to read C3/C4 without overthinking. 👇 Dr Ihab Suliman Dr. Akhil 🇮🇳 Dr Celestino Gutiérrez González MD 🇪🇸🍏🇻🇪 Durga Prasanna Misra Sarah Schafer MD MPH EMJ Nephrology

💊AMITRIPTYLLINE Dosage range is 10mg to 150mg/day. Titrate, titrate, titrate.

Conan Doyle was one of the first Medical Ophthalmologists working within medicine for a few years, and finishing his higher training in Vienna. He struggled initially to find patients so decided to take up writing to pass the time.... The rest is elementary, my dear Watson

FDA Approves 1st new Fibromyalgia drug in 15 yrs - Tonmya (cyclobenzaprine HCl sublingual) as treatment of fibromyalgia in adults. Based on 2 phase 3 trials and 1400+ pts. Dose 2.8 mg tabs 1-2 SL qhs (peak concentration 4.3 hours; t1/2 life = 36 hrs, longer w/ elderly, liver dz)

#myositis #ILD treatment

Sensory neuropathy isn’t one disease. It’s a pattern that only makes sense when you match it with age + phenotype + red flags. Here’s the playbook you’ll want at your fingertips. 🧵 #Neurotwitter , #Medtwitter , Marcus Pinto, MD, MS , Nirmal Pandey MD DM Neurologist , The Wolf of College Street , Witch Doctor of Kochi

Developing patience in life

A 21-year-old man presented with recurrent dactylitis of the index finger (A). Radiography showed osteolytic changes in phalanges of the right index finger, with a honeycomb (or lattice) appearance in P1 & P2 (B, arrowheads), and cystoid lesion in P3 (B, arrow), with thickening

The Feynman Technique:

A quote that lives rent free in my head:

CTD -ILD : Is the cub protecting… or just pretending? Drop your perspective in the comments 👇 #Rheumatology #Immunology #Sullysrounds #MedX #Medtwitter #Mnemonics #Medicine #History Dr. Akhil 🇮🇳 Dr Ihab Suliman Janet Pope Laurent ARNAUD Dr. John Cush #MedTwitter #RheumTwitter

Low back pain at night that wakes patient in 2nd half of sleep, improves with activity? That’s inflammatory back pain – specificity ~97% when ≥4/5 ASAS criteria are met. Mechanical pain never reads the 2 a.m. alarm. Often missed! #medtwitter

Not everything with “lupus” is lupus! 🐺❌ Some diseases carry the name but have nothing to do with systemic lupus erythematosus (SLE). Let’s clear the confusion 1️⃣ Lupus vulgaris ➡️ Chronic cutaneous TB 🦠 ➡️ Painful nodules & ulcers, often disfiguring (“wolf-bite” scars) 2️⃣

👀 Periorbital swelling as the only initial sign. Turned out to be MDA5 dermatomyositis — my 5th such case. This disease hides behind the unusual clues. High suspicion isn’t optional — it can saves lives.

Worth your time 👇 thelancet.com/journals/laneu… #Rheumatology #Immunology #Sullysrounds #MedX #Medtwitter #Mnemonics #Medicine #History Dr. Akhil 🇮🇳 Dr Ihab Suliman Janet Pope Laurent ARNAUD Dr. John Cush #MedTwitter #RheumTwitter Dr Celestino Gutiérrez González MD 🇪🇸🍏🇻🇪