Adeel @oncadeel
Joined February 2020-
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If you're watching the #Titanic story like the rest of the world, let me tell you some things about deep sea physics. 1/ thread
A patient presented with sharp, stinging sensation between the toes while walking and standing along w/intermittent numbness of the left foot. Exam revealed severe tenderness between the 3rd & 4rth toes. Mulder’s sign was positive. What is the likely diagnosis? #medtwitter
1/ This is a standard prescription for viral hepatitis in an admitted patient in India Next time you see this, fight against it This patient suffers from coronary artery disease & has stents placed for the same and has reactivation of hepatitis B infection. Whats wrong here?🧵
Nice diagram depicting assessment of organ perfusion in a patient with #shock using #POCUS + conventional parameters. #MedEd #VExUS #CriticalCare From 🔗link.springer.com/article/10.100…
So here's what can happen to the left atrium when the mitral valve doesn't open properly (stenosis) or close properly (regurgitation) 😱🫀🎈 #anat20070 #mdsa20180
So here's what can happen to the left atrium when the mitral valve doesn't open properly (stenosis) or close properly (regurgitation) 😱🫀🎈 #anat20070 #mdsa20180
One of the things that makes medicine so maddeningly difficult, is also one of the very things that makes it wonderful: You can think you know a patient, understand an illness, and unexpectedly find hidden depths you never knew were there. It’s been a while since I worked. 1/
In November 1970, officials in Oregon, USA decided to blow up a rotting whale carcass. The whole thing went horribly wrong. Why do we bring this up? Well, this story can teach us 3 things about #coronavirus ⬇️
THREAD: Might the death toll from covid-19 be higher than the official fatalities attributed to it so far? Data emerging from the worst-hit places in Europe suggest so. (1/9)
In Italy, >4,000 medical staff have been infected by #coronavirus. At least 18 doctors have died from #COVID19, including several came out of retirement to help. "Heroes don't fall from the sky. They're just ordinary people who bravely stepped forward." 🕯RIP Heroes 🙏
#thoracicthursday from the archives... the day team signs out a post-procedure chest x-ray for you to check and so you do. What do you do next? #radiology
Dyspnea....when the lungs are normal. Sinus tach is the ❤️'s way of telling us there is a problem...somewhere else. A short list of dyspnea + normal lungs: ACS Pulm HTN Bradyarrhythmias Anemia Metabolic acidosis What would you add/delete, #medtwitter?
I hope you brought your appetite and have a strong stomach for... A TASTING MENU OF DERMATOLOGY This 5 course menu is a culinary journey through food-named skin signs. Bon appetit! #prixfixe #tweetorial #MedEd #FOAMEd #dermtwitter #dermatology #medthread h/t @AdamRodmanMD
DIURETIC RESISTANCE (an #UncleBob #5goodminutes tweetorial) 1/ 54 yo man w/ LVEF 30%. D/C from hospital 6 weeks - optivolemic On Lisinopril 20 mg daily, Carvedilol 25 mg bid, Furosemide 80 mg bid He now has dyspnea & peripheral edema &15 lb gain h/t @dhekidney & @kidney_boy
The Cardiac Cycle - Animated via @ThingsWork Search and Bookmark #FOAMed #Meded images on GrepMed.com: #FOAMed #Meded #cardiotwitter images made searchable: "cardiac cycle" -> grepmed.com/?q=cardiac+cyc…
1/ #KashlakChief spends more than #5goodminutes exploring normal anion gap metabolic acidosis (NAGMA) due to CKD. We see many CKD patients on sodium bicarbonate tablets or sodium citrate. This tweetorial will start with why we treat NAGMA. @thecurbsiders
1/ #5goodminutes #KashlakChief has some tweetorial thoughts to add to: Episode 2 – Hyponatremia – The Clinical Problem Solvers clinicalproblemsolving.com/2018/12/09/epi… attn @DxRxEdu @CPSolvers @thecurbsiders Please ask for explanations if any of these points are confusing.
1/ Spend #5goodminutes thinking about refeeding syndrome with #KashlakChief. Refeeding syndrome actually occurs either with decreased glucose intake or total insulin lack. Who gets this syndrome? I have seen it mostly in alcoholics who eschew food.
1/ Spend #5goodminutes thinking about refeeding syndrome with #KashlakChief. Refeeding syndrome actually occurs either with decreased glucose intake or total insulin lack. Who gets this syndrome? I have seen it mostly in alcoholics who eschew food.
1/ Reciprocal creatinine plots (AKA 1/creatinine vs time) - why internists should understand this concept. #5goodminutes #KashlakChief @thecurbsiders I hope @kidney_boy will comment and correct any errors
1/ Why do we administer potassium to a goal of ≥4.0 mEq/L? As an intern, potassium (oral or IV) was likely my most common order. How did this become a key part of inpatient providers' days? Let's have a look at potassium and find out why we "replete".
1/ Understanding the pathophysiology of hyperkalemia in CKD 2-4 - This article - emedicine.medscape.com/article/242494… has a good explanation. "In true hyporeninemic hypoaldosteronism, atrophy of the juxtaglomerular apparatus may be present; this may be more prevalent in diabetics."
1/ Understanding the pathophysiology of hyperkalemia in CKD 2-4 - This article - emedicine.medscape.com/article/242494… has a good explanation. "In true hyporeninemic hypoaldosteronism, atrophy of the juxtaglomerular apparatus may be present; this may be more prevalent in diabetics."
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4K Followers 930 Following she/her, hospitalist at UNC. Always learning. Occasional podcaster. Always looking for opportunities to talk about my dog.1/2 Here is food for thought: 1. O2 delivery = cardiac output (CO) x O2 content of blood 2. CO is inversely proportional to Hct (owing to effect on viscosity) 3. O2 content is directly proportional to Hb
2/2 4. Thus, O2 delivery is proportional to Hb/Hct 5. MCHC = Hb/Hct 5. Therefore, O2 delivery is proportional to MCHC Hmmm!
@MarkELindsay They explicitly did not mention a CBC
Watch this mind-blowing dynamic MRI and look what happens to the airway with various head and neck positions This is why basic airway maneuvers save lives! #FOAMed
@themontsd How do you learn about mold and water damage risk factors?! (Thanks in advance!)
👴 w Cirrhosis ➡️🏥 with spontaneous bacterial peritonitis and septic shock After fluid resuscitation, vasopressors and antibiotics shock resolved However now with oliguria and ⬆️ Na (165 meq/L). Cr 1.0 mg/dl, BUN 30 mg/dl 1/10
Amlodipine comes is three doses: placebo (2.5mg), treatment (5mg), and leg swelling (10mg).
Probably the best thing you'll see today. In 2017, a group of developers hilariously competed for who could create worst volume control interface in the world. The results 🧵 1/22
Please AVOID supplements with high dose of Nicotinamide or Niacin. It can lead to liver injury and liver failure. Niacin or nicotinic acid is vitamin B3. Niacin is used ONLY for treating pellagra caused by vitamin B3 deficiency. Since Niacin has a major ncbi.nlm.nih.gov/pmc/articles/P……
Ramzan-transmissions are the most toxic depiction of religio-Capitalism. Movie stars turned in2 self-styled holy men for 30 days,dressed in flamboyant attires,surrounded by branded bottles of Pepsi &Rooh Afza,praying in one segment & throwing Q-mobile at the audience in the next.
Finished a week on the wards Here are 10 teachable moments (TM)
Unless you’re concerned your patient is going to need surgery or bleed imminently, unfractionated heparin is kind of a trash drug.
This one was very easy to crack Patient says, "I am unable to sleep at night." Sometimes, doctors are the reason for insomnia, not a disease.
1/ This is a standard prescription for viral hepatitis in an admitted patient in India Next time you see this, fight against it This patient suffers from coronary artery disease & has stents placed for the same and has reactivation of hepatitis B infection. Whats wrong here?🧵
Elderly woman with heart failure and recurrent decompensation of ❓ etiology Cr of 1.4 has been unchanged (eGFR ~35) but cystatin C reveals a different story ➡️ progressive cardiorenal decline as poss cause Critical to remember limits of Cr and sarcopenia in the elderly
Controversial opinion: there should not be a “zero falls” goal or “X days since last fall” pride in hospital nursing units. It leads us to shackle many people to their beds unnecessarily, causing physical and psychological harms. 1/6
@Dr_Oubre a lot of this coding is due to risk. afib had strokw risk which is high cost and being in anticoagulants also increases risk