Discover and read the best of Twitter Threads about #DDX
Most recents (13)
1) Welcome to a new #accredited #tweetorial in our series of educational programs on #hypertrophic #cardiomyopathy #HCM. Previous programs, still available for 🆓CE/#CME, are at cardiometabolic-ce.com/category/hcm/.
Now you can earn another 0.75hr credit by following this 🧵!
Now you can earn another 0.75hr credit by following this 🧵!
2) Our expert author is JA Linderbaum MS, ARNP, FACC, FPCNA @jlinderbaum, Associate Professor of Medicine, @MayoClinic, CV #NursePractitioner, Assoc. Medical Editor #AskMayoExpert.
#FOAMed #MedEd @MedTweetorials #CardioTwitter @transformingHC @TNPJ_Journal #cardiology
#FOAMed #MedEd @MedTweetorials #CardioTwitter @transformingHC @TNPJ_Journal #cardiology
3) This program is supported by an unrestricted educational grant from Bristol Myers-Squibb. Statement of accreditation and faculty disclosures at cardiometabolic-ce.com/disclosures/. Credit for #physicians #nursepractitioners #physicianassociates #nurses #pharmacists from @academiccme.
#Navantia🇪🇸⚓️
Projet #SMART8000
➡️ #IndoPacific2022 : @Navantia_AU a présenté - pour la 1ière fois - la SMART 8000 (#NS8K ?) de 120 mètres de long, 8 à 10 000 t et dont presque toutes les antennes sont intégrées ou conformes à la coque (photographies 1, 2 : RT @sweeneygov).
Projet #SMART8000
➡️ #IndoPacific2022 : @Navantia_AU a présenté - pour la 1ière fois - la SMART 8000 (#NS8K ?) de 120 mètres de long, 8 à 10 000 t et dont presque toutes les antennes sont intégrées ou conformes à la coque (photographies 1, 2 : RT @sweeneygov).
1) Welcome to a new #accredited #tweetorial about an important complication of #pulmonaryembolism (#PE): chronic thromboembolic pulmonary hypertension #CTEPH. Follow this thread to earn 0.75h CE/#CME #physicians #physicianassociates #NPs #nurses #pharmacists.
2) I am Jason Weatherald @AlbertaPHdoc of @UAlberta and you may recall my previous tweetorial in this feed. It's still available for credit at cardiometabolic-ce.com/pah2/. @cardiomet_CE is your ONLY home for earning CE/#CME entirely on Twitter! Howdy to @vic_tapson @lauralynndonah1
3) This program is intended for #healthcare providers and is supported by educational grants from Actelion, Bayer, Chiesi, & AstraZeneca. Faculty disclosures are listed at cardiometabolic-ce.com/disclosures/. Prior programs, still available for credit, are at cardiometabolic-ce.com
1/ Welcome back to 12-Lead Thursday #MedTwitter !
Let’s get the juices flowing with an EKG! What are the major abnormalities?
Let’s get the juices flowing with an EKG! What are the major abnormalities?
2/ Yes, those are inferolateral ST elevations!
And notice the underlying rhythm of atrial fibrillation
And notice the underlying rhythm of atrial fibrillation
3/ Continuing our patient story, the patient was taken emergently to the cath lab where angiography revealed...
Normal coronary arteries!
Normal coronary arteries!
1/9 #Morningreport recently @SinaiBmoreIMRes
by M. Thomas featured a middle aged pt presenting with sudden collapse whilst getting ready in the morning.
No prodromal episodes
#DDx ?
#MedTwitter #MedStudentTwitter #FOAMed
by M. Thomas featured a middle aged pt presenting with sudden collapse whilst getting ready in the morning.
No prodromal episodes
#DDx ?
#MedTwitter #MedStudentTwitter #FOAMed
2/9
For acute collapse, this would need to be defined along the spectrum of:
Pre-syncope-> Syncope-> Near SCD-> SCD.
For acute collapse, this would need to be defined along the spectrum of:
Pre-syncope-> Syncope-> Near SCD-> SCD.
3/9
A quick review of medications show multiple medications that can present with this condition:
A quick review of medications show multiple medications that can present with this condition:
1/10 #Morningreport recently
@SinaiBmoreIMRes by S. Sridhar recently featured a pt with a 3 week history of generalized pruritic rash
#DDx ?
#MedTwitter #MedStudentTwitter #FOAMed
@SinaiBmoreIMRes by S. Sridhar recently featured a pt with a 3 week history of generalized pruritic rash
#DDx ?
#MedTwitter #MedStudentTwitter #FOAMed
2/10 The rash was insidious in onset, initially involving extremities and progressed to involve rest of the body, sparing face, palms, and soles.
Reports ~40 lb unintentional weight loss in previous 4-5 months.
Ddx for this rash would be :
emedicalhub.com/maculopapular-…
Reports ~40 lb unintentional weight loss in previous 4-5 months.
Ddx for this rash would be :
emedicalhub.com/maculopapular-…
3/10
Vital Signs: T-36.2, HR-92, RR-16, BP-109/75
Physical Exam:
Diffuse, erythematous, macular rash involving majority of bilateral upper and lower extremities, anterior and posterior trunk and abdomen.
Left occipital LN 1cm +. Rest of the examination was normal
Vital Signs: T-36.2, HR-92, RR-16, BP-109/75
Physical Exam:
Diffuse, erythematous, macular rash involving majority of bilateral upper and lower extremities, anterior and posterior trunk and abdomen.
Left occipital LN 1cm +. Rest of the examination was normal
1/10 #Morningreport recently @SinaiBmoreIMRes
by N.Rapista recently featured an elderly pt with an episode of dysphagia x 1 week
#DDx ?
#MedTwitter #MedStudentTwitter #FOAMed
by N.Rapista recently featured an elderly pt with an episode of dysphagia x 1 week
#DDx ?
#MedTwitter #MedStudentTwitter #FOAMed
2/10 Further history:
Unable to swallow any solid food
• “held in the throat”
• coughing frequently
• Generalized malaise
• New left ptosis
Unable to swallow any solid food
• “held in the throat”
• coughing frequently
• Generalized malaise
• New left ptosis
3/10EXAM:
T: 36.4°C BP: 139/69 HR: 68 RR: 18 SpO2: 100% on room air
Gen: Awake, alert
HENT: Left ptosis
Neuro: A&Ox3, CN 2-12 grossly intact. Moves all extremities spontaneously, 5/5 all extremities but had some fatigue and dropped to 4/5 with resistance. Cerebeller Neg
T: 36.4°C BP: 139/69 HR: 68 RR: 18 SpO2: 100% on room air
Gen: Awake, alert
HENT: Left ptosis
Neuro: A&Ox3, CN 2-12 grossly intact. Moves all extremities spontaneously, 5/5 all extremities but had some fatigue and dropped to 4/5 with resistance. Cerebeller Neg
1/#Morningreport @SinaiBmoreIMRes
by @NasirAlhamdan featured a presentation of progressive fatigue and tachypnea X 2 months. This presentation opens up a significant number of #DDx's !
#MedTwitter #MedStudentTwitter
by @NasirAlhamdan featured a presentation of progressive fatigue and tachypnea X 2 months. This presentation opens up a significant number of #DDx's !
#MedTwitter #MedStudentTwitter
2/Other findings were:
-unexplained weight loss.,
- Tachypnea & mild SOB
- Intermittent chronic diarrhea, Intermittent small amount of bright blood per rectum
- Bruises on thighs
Now the DDx shift from the respiratory system to maybe an overlap of a hematologic etiology
-unexplained weight loss.,
- Tachypnea & mild SOB
- Intermittent chronic diarrhea, Intermittent small amount of bright blood per rectum
- Bruises on thighs
Now the DDx shift from the respiratory system to maybe an overlap of a hematologic etiology
3/A quick overview of our thoughts were:
1/#Morningreport @SinaiBmoreIMRes
featured a young patient presenting with abdominal pain X 2 weeks with a serum K=2.8.
There was also increased urinary frequency
some weakness and fatigue during the past 2 weeks
#DDX #MedTwitter #medstudents #FOAMed
featured a young patient presenting with abdominal pain X 2 weeks with a serum K=2.8.
There was also increased urinary frequency
some weakness and fatigue during the past 2 weeks
#DDX #MedTwitter #medstudents #FOAMed
2/The DDX for Hypokalemia requires consideration of a 3 pronged approach: 1)Decreased intake 2)Renal and GI losses and 3) IC shifts.
3/For the workup: Spot urine potassium and 24 hour urinary Potassium suggested urinary K wasting.
[UK] high (>40 mEq/L) =renal K loss
TTKG of 9 was concerning for renal potassium wasting
In hypokalemia (K⁺ <3.5 mEq/L), the TTKG > 7 suggests renal K wasting.
[UK] high (>40 mEq/L) =renal K loss
TTKG of 9 was concerning for renal potassium wasting
In hypokalemia (K⁺ <3.5 mEq/L), the TTKG > 7 suggests renal K wasting.
1/6 @k_vaishnani discussed Cement PE recently and it reminded me of a patient I had with N/V due to a procedural complication that I was also not familiar with. A great learning point is to try to associate the procedure to the complication whilst trying to entertain other #DDX
2/6 The patient presented with a past medical history of DM and paroxysmal AFib s/p Ablation two days prior to admission.
One day after the procedure, she developed generalized progressive abdominal discomfort (+) persistent n/v, exacerbated with food intake.
One day after the procedure, she developed generalized progressive abdominal discomfort (+) persistent n/v, exacerbated with food intake.
3/6 The abdominal pain was diffuse and intensity was 6/10 Intermittent and relieved by vomiting.
It was associated with palpitations and diaphoresis. The team ran through causes of abd pain via @CPSolvers schema. Her labs showed met. alkalosis /dehydration from excessive vomiting
It was associated with palpitations and diaphoresis. The team ran through causes of abd pain via @CPSolvers schema. Her labs showed met. alkalosis /dehydration from excessive vomiting
1/ A 46-year-old man with a history of #malaria presented to the @JohnsHopkinsDOM on 8/12/1923 with
-- 3 years of generalized arthralgia
-- intermittent joint swelling
-- 40 lbs weight loss
@CPSolvers @DxRxEdu #medtwitter #MedEd
-- 3 years of generalized arthralgia
-- intermittent joint swelling
-- 40 lbs weight loss
@CPSolvers @DxRxEdu #medtwitter #MedEd
2/ Exam
-- synovitis of the 2nd and 3rd MCPs
-- diffuse joint tenderness
-- lymphadenopathy
-- pyorrhea alveolaris* of the few remaining teeth.
What do you want to do next? What's your #DDX?
Remember: Sir William Osler died in 1919, so it's all you...
-- synovitis of the 2nd and 3rd MCPs
-- diffuse joint tenderness
-- lymphadenopathy
-- pyorrhea alveolaris* of the few remaining teeth.
What do you want to do next? What's your #DDX?
Remember: Sir William Osler died in 1919, so it's all you...
So far, we have #tuberculosis on the differential. “Consumption” or “#phthisis”, wasting away, as #Tb was often referred to, certainly could explain this patients weight loss and adenopathy.
But does it explain the rest?
But does it explain the rest?
Last week we had our traditional lecture on Dizziness by our amazing PD, Dr @AndrewGutwein!...
As you are probably very aware, this is a very common complain!, and can have many subtleties.
1/n
#JacobiIM #JacobiNoonConference #medtwitter #FOAMed #DDx @CPSolvers @DxRxEdu
As you are probably very aware, this is a very common complain!, and can have many subtleties.
1/n
#JacobiIM #JacobiNoonConference #medtwitter #FOAMed #DDx @CPSolvers @DxRxEdu
Dizziness is VERY relative...
Patient can describe it as spinning, lightheaded, "blacking out", but sometimes, it is just "Dizziness".
Newman et al evaluated the overlap of dizziness categories based on symptoms. (May Clin Proceedings, 2007-11-01,Vol 82,1)
2/n
#JacobiIM
Patient can describe it as spinning, lightheaded, "blacking out", but sometimes, it is just "Dizziness".
Newman et al evaluated the overlap of dizziness categories based on symptoms. (May Clin Proceedings, 2007-11-01,Vol 82,1)
2/n
#JacobiIM
But if it is just dizzy...DON'T STOP AT "JUST DIZZY"...try to really understand what is it!....As Dr Gutwein, says, "Dizziness is Meaningless".
A good way to try to understand what the patient means is:
3/n
#JacobiIM
A good way to try to understand what the patient means is:
3/n
#JacobiIM
Another #12LeadThursday, another EKG puzzle to keep you thinking until the weekend. #cardiotwitter #EKG #ECG #medtwitter
