#3 Exceptions to guideline-directed HTN emergency treatment ❗️Aortic dissection: target SBP<120 within 20 min ❗️ACS: SBP<140 to decrease myocardial O2 demand ❗️Ischemic stroke: Lower if SBP>220 (no tPA), maintain permissive HTN ❗️ICH: SBP<140 rapidly ❗️Acute pulm edema: Avoid BB

#6 🫁 RML vs RLL on CXR? ➡️ Right Middle Lobe •Obscures right heart border •Anterior on lateral view ⬇️ Right Lower Lobe •Obscures right hemidiaphragm •Posterior/inferior on lateral view 🧠 “Silhouette sign” #MedTwitter #CXR

#7 “Anti-anti-anti syndrome” 🧪 Tox slang for a confusing toxidrome cocktail 🤯 👁️ Conflicting signs that do not fit into one toxidrome 💊 Combo of anticholinergic, cholinergic, sedatives, sympathomimetic and more! 🔍 Think polypharmacy overdose 🚨 #Toxidromes #MedTwitter

Ending the week with a tweetorial! A patient comes to the hospital, he's young, lives in a dorm (buzzword!) and his roommate has noticed he has been increasingly lethargic over the last few days. He is febrile, drowsy and has a severe headache on your assessment. What next?

🚨~80% asthma patients use inhalers incorrectly and 67% of clinicians struggle to teach proper technique. This misuse costs the U.S. $7–15B/year and worsens asthma outcomes. Time to fix inhaler education. Here is a script clinicians can use to educate patients and themselves🫁

🚫 Daptomycin is ineffective for MRSA pneumonia - it is inactivated by pulmonary surfactant. 🦠 For patients with CKD, consider: -Linezolid (non-renally cleared) -Vancomycin (requires close monitoring) -Ceftaroline (not first-line) #MRSA #Pneumonia #Antibiotics #IDtwitter