💧Fluid creep accounts for more fluid than resuscitation in ICU. But nobody prescribes it — and most don’t even notice it. The truth? 🧨 Most ICU patients don’t need routine maintenance fluids. Here’s what’s really going on 👇🧵

🔚 Final Note: 🧠 Nails are not just cosmetic – they’re vascular, immunological, and diagnostic maps. Don’t ignore the tips of the fingers — they might point to the diagnosis. 📌 Save this thread 💬 Share with juniors 👣 Follow Aravind Palraj for more rheum pearls

🧵 10 Radiological Signs Every Rheumatologist Must Know Imaging doesn’t lie. Sometimes, it screams. Here are 10 classic radiological signs in rheumatology you should never miss 👇 #RheumTwitter #Radiology #MedTwitter #MSKImaging #Autoimmune Dr. Akhil 🇮🇳 Dr Ihab Suliman

🧵 10 Rheumatology Diagnoses You Can Make Without a Single Positive Lab Yes — zero lab positivity. Because in rheumatology, clinical pattern is king. #RheumTwitter #MedTwitter #Autoimmune Dr Ihab Suliman Janet Pope

NEW on the #AJKDBlog: Timothy Yau interviews Roger Rodby and Bill Whittier about a recent AJKD Review focusing on measurements of proteinuria. bit.ly/4oax9Zh (FREE)

Ever wonder why bruises change color? Red → Blue → Green → Yellow → Brown That’s hemoglobin breaking down: 🔴 Oxy Hb → 🔵 Deoxy Hb → 🟢 Biliverdin → 🟡 Bilirubin → 🟤 Hemosiderin Your skin becomes a living chemistry timeline. #Hematology #MedEd

Patient presents with bone pain, diabetes and progressive neurologic symptoms. Diagnosis & treatment?

🧵 "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. 👇

🧵 What is Critical Closing Pressure — and why does it matter for perfusion? A thread to clear up one of the most misused and misunderstood ideas in circulatory physiology. 👇

🔍Proteinuria in monoclonal gammopathy? Don’t miss the diagnostic clues! 🚰uAPR < 40%? Think tubular 🧪uAPR > 40%? Glomerular path ahead From cast nephropathy to MGRS, biopsy is 🔑 📉LC ≤10%= cast nephropathy 📊LC >10%= #LCPT 🧬 #MGRS = Biopsy it 📖doi.org/10.1016/j.lpm.…

On the #AJKDBlog, catch up on these commentaries with: - Diana Mahbod, MD, CPE, FASN, FNKF asks whether vadadustat could reshape anemia management - Mahmood & Morales discuss intensive BP control in CKD - Akshta Pai asks how old is too old to be a living kidney donor? bit.ly/3XNJ0Qs FREE

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🧵 CRP vs Procalcitonin – Inflammation vs Infection? Both rise in systemic illness. But they don’t speak the same language. Let’s break down when to use CRP, when to trust Procalcitonin—and when both lie. 👇 Dr Ihab Suliman Dr. Akhil 🇮🇳 Janet Pope the EMCrit Crew Dr Andrew Suleh MD

Remember… (The statement can be extrapolated to IVC #POCUS)

🧵 ANA Testing in Rheumatology — Masterclass for Doctors & MedTwitter 1/ 📢 What’s ANA? ANA = Anti-Nuclear Antibodies. It’s a surrogate marker for >50 nuclear antigens (Ro, Sm, dsDNA, La, Scl-70, etc). ✅ Can be positive in many CTDs ❌ Positive ≠ disease ❌ Negative ≠ rule

This is a fascinating case: A 60 yo man presents with paranoia, new-onset facial acne & cherry angiomas, fatigue, insomnia, ataxia, and polydipsia. He has an extremely unusual diet.🧂 His labs are👇 (note that anion gap!): What could be going on? 1/

1/21 Acid–base interpretation often feels like a maze. But there’s a simple way to make sense of it at the bedside. It starts with pH, strong ions, and base excess.

🧵 Part 2. Heterogeneity vs Colliders in Critical Care RCTs 1. The puzzle Critical care RCTs keep failing. The usual explanation? “Patients are too heterogeneous.” That’s partly true — but there’s a deeper problem. Part 2 of a 3-thread series on why ICU trials fail and why

🧵 ALT vs AST :- Significance of zonation in interpreting patterns of enzyme elevations A thread 🧵-

We’re proud to share 3 historic breakthroughs Mass General Transplant ✅3rd kidney xenotransplant completed at MGH — patient thriving at 90 days ✅7+ months dialysis-free: longest survival w/ a pig kidney ever ✅FDA clears larger trial eGenesis MassGeneral Medicine Mass General Surgery Mass General Brigham Nephrology