Discover and read the best of Twitter Threads about #peds
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Differential Diagnosis for cortically based masses
P-DOG 🐶
1️⃣Pleomorphic Xanthoastrocytoma (PXA)
2️⃣Dysembryoplastic neuroepithelial tumor (DNET)
3️⃣Oligodendroglioma
4️⃣Ganglioglioma
#Neurology #neurosurgery #peds #radres #neurotwitter @The_ASPNR @TheASNR #MedTwitter
P-DOG 🐶
1️⃣Pleomorphic Xanthoastrocytoma (PXA)
2️⃣Dysembryoplastic neuroepithelial tumor (DNET)
3️⃣Oligodendroglioma
4️⃣Ganglioglioma
#Neurology #neurosurgery #peds #radres #neurotwitter @The_ASPNR @TheASNR #MedTwitter
1️⃣PXA
Originate in the subpial astrocytes typically in children and young adults often with a seizure history
Temporal lobe is most common
Originate in the subpial astrocytes typically in children and young adults often with a seizure history
Temporal lobe is most common
Imaging (variable):
▶️Classically appear as a cortically based mass with cyst and enhancing nodule and overlying DURAL TAIL or enhancing leptomeninges
▶️Calcifications are RARE
▶️Classically appear as a cortically based mass with cyst and enhancing nodule and overlying DURAL TAIL or enhancing leptomeninges
▶️Calcifications are RARE
Child with a history of dental caries presents with a firm mass at the angle of the mandible. What is the most likely diagnosis? 🤔 🧠
#neurotwitter #ent #peds #Neurology #neurosurgery @ASHNRSociety @The_ASPNR #MedTwitter
#neurotwitter #ent #peds #Neurology #neurosurgery @ASHNRSociety @The_ASPNR #MedTwitter
Answer: Sclerosing osteomyelitis of Garré
▶️Biopsy showed a reactive and reparative osseous process and bone culture grew oral flora (though cultures are usually negative)
▶️Biopsy showed a reactive and reparative osseous process and bone culture grew oral flora (though cultures are usually negative)
▶️SOG is thought to be due to a low grade infection possibly 2/2 dental disease. However, there should be no signs of acute infection (suppuration, bony sequestration or draining tracts)
Case of emphysematous epiglottitis in an adult
Epiglottitis is an emergency as it can potentially cause airway compromise especially in children who have smaller airways #neurotwitter #ent #peds #Neurosurgery #MedTwitter #MedEd @ASHNRSociety
Epiglottitis is an emergency as it can potentially cause airway compromise especially in children who have smaller airways #neurotwitter #ent #peds #Neurosurgery #MedTwitter #MedEd @ASHNRSociety
▶️In children the diagnosis can be confirmed with upright plain film. CT requires placing the patient supine which may exacerbate inspiratory strider
▶️In adults, the diagnosis may not be suspected clinically so patients may end up with a CT scan as in this case
▶️In adults, the diagnosis may not be suspected clinically so patients may end up with a CT scan as in this case
▶️Bacterial infection typically 2/2 H. Influenza in unvaccinated children
▶️In adults, possible pathogens include Strep, Staph, and H. influ
▶️In adults, possible pathogens include Strep, Staph, and H. influ
Case of diffuse CSF seeding of tumor in this patient w/ WHO grade 4 diffuse hemispheric glioma
#NeuroTwitter #neurosurgery #Neurology #peds #futureradres @The_ASPNR #MedEd
#NeuroTwitter #neurosurgery #Neurology #peds #futureradres @The_ASPNR #MedEd
▶️Prospectively this mass was thought to be an embryonal tumor w/ multilayered rosettes given the marked diffusion restriction, hemorrhage, and lack of surrounding edema 🧠
Imaging:
▶️T2 shows a heterogenous slightly hyperintense mass w/ areas of hypointensity
▶️No surrounding edema/infiltrating tumor is seen on T2/FLAIR
▶️Fluid-fluid level is seen suggestive of hemorrhage (arrow)
▶️T2 shows a heterogenous slightly hyperintense mass w/ areas of hypointensity
▶️No surrounding edema/infiltrating tumor is seen on T2/FLAIR
▶️Fluid-fluid level is seen suggestive of hemorrhage (arrow)
What is the most likely diagnosis in this adolescent with seizure? 🧠
(Sorry I have no CT without)
#neurotwitter #peds #Neurosurgery #Neurology @The_ASPNR @TheASNR #MedTwitter
(Sorry I have no CT without)
#neurotwitter #peds #Neurosurgery #Neurology @The_ASPNR @TheASNR #MedTwitter
What is the most likely diagnosis?
Answer: Confirmed supratentorial ependymoma
Predicting tumors is incredibly challenging in the absence of specific features …some learning points on the case in 🧵
Predicting tumors is incredibly challenging in the absence of specific features …some learning points on the case in 🧵
Let me paint a picture of #peds #emergency care for you.
Let's say your 3 year old bonks his head on the coffee table right before dinner. Nothing horrible, but needs stitches. You take him to urgent care. They tell you that they can't fix it, and you need to go to the ER.
1/
Let's say your 3 year old bonks his head on the coffee table right before dinner. Nothing horrible, but needs stitches. You take him to urgent care. They tell you that they can't fix it, and you need to go to the ER.
1/
You get to the ER. It's 8 pm, the waiting room is about half full, and you think - "Ok, this may not be so bad. Maybe we will be home by midnight."
But a few hours later, all that's happened is that a nurse has taken his vitals. Your 3 yo is exhausted and so are you.
2/
But a few hours later, all that's happened is that a nurse has taken his vitals. Your 3 yo is exhausted and so are you.
2/
Meanwhile, here's what's going on in the back.
There are no ICU beds. There are 2 kids in the ER who need the ICU. One is a bit sicker than the other, so the ICU is making room.
In the meantime, 1 nurse is dedicated to this very sick child needing constant monitoring.
3/
There are no ICU beds. There are 2 kids in the ER who need the ICU. One is a bit sicker than the other, so the ICU is making room.
In the meantime, 1 nurse is dedicated to this very sick child needing constant monitoring.
3/
An in-depth review of pediatric femoral shaft fractures.
If you're interested in orthopedics or pediatrics you'll definitely want to check this review out!
1/10
If you're interested in orthopedics or pediatrics you'll definitely want to check this review out!
1/10
Pediatric femoral shaft (PFS) fractures constitute a small portion of pediatric fractures roughly 1-2% with a bimodal age distribution
Most common causes:
✯ Toddlers: falls
✯ Teenage/adolescent: MVA
Most common causes:
✯ Toddlers: falls
✯ Teenage/adolescent: MVA
In children younger than walking age child abuse must be suspected. As high as 80% of PFS fractures in this age group are due to child abuse.
In the toddler age group as high as 25% of PFS fractures are due to child abuse, so it must be ruled out.
In the toddler age group as high as 25% of PFS fractures are due to child abuse, so it must be ruled out.
It’s the first week of residency for many incoming residents this week. I remember my first day @usask so vividly: I was so stressed out that I developed tinnitus and asked my senior to examine my ears because I thought I was suddenly becoming deaf. Everyone: take deep breaths.
I have one advice: you are NEVER alone. Don’t ever think that you need to suffer in silence. If you don’t know something, it’s normal! You’re not supposed to know anything: that’s why you’re where you are. No one expects PGY1s to be experts in their fields.
Your co-residents will become your family. You will look after each other. That is so precious and will last your entire career. But also remember that your staff is here for you: you need a shoulder to cry on? You need a hug? You need a warm supper? We’re all over this. Call us.
1/x🧵- 96% of med schools in the US & Canada have ZERO dedicated, compulsory pain education.
...YUP.😳
No wonder we continue to throw pills at pain!!
To attempt to remedy this, my @UCSF @UCSFBenioffOAK colleagues & I piloted a pain training for #peds residents, & collected data.
...YUP.😳
No wonder we continue to throw pills at pain!!
To attempt to remedy this, my @UCSF @UCSFBenioffOAK colleagues & I piloted a pain training for #peds residents, & collected data.
2/x- It was an amazing experience.
Turns out pain education changes the way physicians treat pain. 🤦🏻♀️
Our results confirm & the paper was just published🌟
Please share if useful:
doi.org/10.1016/j.ctim…
Turns out pain education changes the way physicians treat pain. 🤦🏻♀️
Our results confirm & the paper was just published🌟
Please share if useful:
doi.org/10.1016/j.ctim…
3/x- Physicians reported having a better understanding of the biopsychosocial nature of pain, + increased likelihood of using nonpharm treatments like #CBT, mindfulness & biofeedback.
What will it take to implement *mandatory* pain education in ALL med schools⁉️⁉️
#medtwitter
What will it take to implement *mandatory* pain education in ALL med schools⁉️⁉️
#medtwitter
Hard to believe #PGY4 is here! Grateful for the opportunity to share more about #HAES and #IntuitiveEating with fellow trainees in #peds today for my senior talk. I learned so much along the way I thought I might create a brief #tweetorial of the summary of my literature review.
#HAES or health at every size is a method of nutrition counseling focused on promoting body acceptance, encouraging nutrition 🍎, and gentle movement 💪 without an aim of weight loss.
In brief: pursuing health-promoting habits at any weight/body size.
In brief: pursuing health-promoting habits at any weight/body size.
A 2013 study in @JAMAPediatrics showed children whose parents used “weight-centered” language were more likely to diet frequently, binge eat, or have eating disorders as teens.
Parents that focused on healthy eating ONLY had a protective effect on all the above for their teens.
Parents that focused on healthy eating ONLY had a protective effect on all the above for their teens.
