A.Kumar

Medico || Views are Personal || RTs aren't Endorsement #MedTwitter #MedX

[Dr.Priyanshu Jaseja @PJaseja]

Saved this statement long back...

Neutrophil-to-Lymphocyte Ratio (NLR) is a poor man’s cortisol test
#MedTwitter

[Dr. Kratik Agarwal @_Kratik_Agarwal]

🚨Cardiac physiology concept for upcoming INICET exam.

If I had to bet on a future question, it’d be from this topic.

📖 First Aid explains the core concept beautifully and my annotations tie it all together for quick revision. Save this one!
#inicet #neetpg

[Dr. Priyam Bordoloi @DocPriyamMD]

Med students, listen up! Today let me explain how to analyze a Liver Function Test (LFT) step by step.
​Stop looking at isolated HIGH or LOW flags on a lab report. You need to look at the patterns. Here is how you actually read an LFT panel like a CONSULTANT 👇 (1/10)

[Dr. Kratik Agarwal @_Kratik_Agarwal]

If ABGs have ever felt confusing, this might be the only summary you'll need before the exam.

Built this one page cheat sheet to simplify acid-base disorders, compensation rules, anion gap analysis, and mixed disorders.

Everything you need to crack ABG fast 👇
#medtwitter

[Dr Kamlesh Darji @DrKamleshDarji1]

After reading this post, you'll never need motivation to study again: 🔥

It's 2026. Butterfly rash, you think lupus, you order ANA and anti-dsDNA - both positive. You start hydroxychloroquine. Clean diagnosis.
Then the patient opens ChatGPT - and stops accepting anything until the machine confirms it.
First it's the sensitivity of ANA, the specificity of dsDNA. Fair enough. But then they ask GPT a different question: "what should I ask my doctor to expose him?" bot replied: Why didn't he order the most specific test. Why no extra screening. Why this drug and not another. Why wasn't I told it causes that side effect in X% of patients.
And a certain kind of person doesn't stop there. They film it. They write the thread. They build a following out of "my doctor didn't know" (literally go on Insta and watch) and once it's personal, it stops being medical. They come for your name, your caste, your religion, where you're from. One wrong answer becomes a whole character.
This is the new reality. Anyone with a ₹2000 subscription thinks they can trash you with bot knowledge.
So there's one move left. Read deeper than the chatbot can - not summaries, but basics, full articles, the false positives, the exceptions, the rare 1%. Do the experimental work your institute actually allows. Build it quietly, until one day you cite one obscure paper the machine never surfaced, and the whole "gotcha" collapses.
Be smarter than GPT. Not louder. Smarter.

[Dr M Shujat Rasool @DrMShujat]

A consultant once said during ER round:

“Most juniors don’t struggle with abdominal pain because they don’t know the causes. They struggle because they approach every patient randomly.”

A safe approach to abdominal pain starts with one question👇

[Dr. Suraj Baidya @OPDDiaries]

Itch (pruritus) is transmitted primarily by specialized unmyelinated C-fibers, which project to neurons in the dorsal horn of the spinal cord.

When you scratch, you mechanically stimulate the skin and activate nociceptive Adelta and C fibers that carry mild pain signals.
These pain signals recruit inhibitory interneurons in the dorsal horn, suppressing the transmission of pruriceptive signals. In other words, the nervous system uses pain to inhibit itch.

Some studies also show that scratching activates central reward pathways, producing a brief sensation of relief that reinforces the behavior. This is why scratching often feels so satisfying.

However, excessive scratching damages the epidermal barrier, promotes the release of inflammatory mediators (including histamine, cytokines, and proteases), and sensitizes peripheral nerve endings.
The result is the itch-scratch cycle.

[Internal Medicine @pgMedicine]

Iron Studies Made Simple: A Pattern-Based Approach to Microcytic Anemia

[Rafael Sirera @ProfSirera]

ESR tells you that inflammation has left a slow systemic footprint.
CRP tells you that the liver is actively responding to cytokines
Procalcitonin tells you that the inflammatory programme may be bacterial or septic in nature.
They are not interchangeable clocks.
They are different biological readouts.

[Aditya Gupta @DrAditya2935]

Glycogen Storage Diseases.

You were once a NEET/JEE topper, now struggling again for NEET PG.
So, mnemonic is the same.

Voh Physics Chemistry Aur Maths main Hoshiar Tha

Voh. Von Gierke (I)
Physics Pompe’s (II)
Chemistry Cori (III)
Aur Anderson (IV)
Maths main Mccardle (V)
Hoshiar Hers (VI)
Tha. Tarui (VII)

Mnemonic doesn’t end here.

Von gierke is first - affects the last enzyme of gycogenolysis - Glucose 6 P04tase (glucose 6 phosphate to glucose - last enzyme)

P for pompe, p for pediatric - children have good hearts - affects heart.

C for Cori. After C comes D - Debranching enzyme is absent.

A - Anderson - after A comes B - branching enzyme is absent.

M for Mccrdle , m for muscle phosphorylase.

H for Her, H for hepatic Phosphorylase.

[Dr M Shujat Rasool @DrMShujat]

“Creatinine is raised.” This is one of the most common and most dangerous oversimplifications in medicine.

Renal parameters are not just “normal” or “abnormal.” They tell you about perfusion, dehydration, sepsis, obstruction, drug toxicity, chronic kidney disease, and sometimes an approaching need for dialysis.

Here’s a practical approach every doctor should know 👇

[Dr M Shujat Rasool @DrMShujat]

IV Labetalol ➡️ Emergency Doses👇

➡️ General Hypertensive Emergency

• 20 mg IV over 2 min
• Then 20–80 mg every 10 min
• Max: 300 mg
• Infusion: 0.5–2 mg/min

➡️ Intracerebral Hemorrhage / Hemorrhagic Stroke

• 10–20 mg IV over 1–2 min
• Repeat or start infusion if needed

Ischemic Stroke (when BP lowering indicated)

• 10–20 mg IV over 1–2 min
• May repeat once

➡️ Severe Pre-eclampsia / Eclampsia

• 20 mg IV
• Then 40 mg after 10 min
• Then 80 mg every 10 min if BP remains high
• Max: 220–300 mg

➡️ Aortic Dissection

• 20 mg IV bolus
• Then infusion 0.5–2 mg/min
• Goal HR <60/min before vasodilators

➡️ Hypertensive Emergency with AKI

• 20 mg IV over 2 min
• Then 20–80 mg every 10 min
• Or infusion 0.5–2 mg/min

➡️ Avoid / Use cautiously in:

• Asthma or active bronchospasm
• Bradycardia
• Heart block
• Acute decompensated heart failure

[Dr M Shujat Rasool @DrMShujat]

Palpation &amp; Percussion of Liver — Resident Level Clinical Scheme

➡️ Preparation &amp; Position

Patient supine
Head slightly elevated
Knees flexed to relax abdomen
Expose from chest to pubic symphysis
Examine from patient’s right side
Warm hands before examination👇

[Dr M Shujat Rasool @DrMShujat]

Hypertensive Urgency Treatment for Residents, House Officers & Medical Officers👇

Hypertensive urgency = BP ≥180/120 mmHg BUT no signs of acute end-organ damage.
If there IS chest pain, SOB, neuro deficit, seizures, vision loss, oliguria → that’s emergency, not urgency. Send to ER + IV.

[Dr M Shujat Rasool @DrMShujat]

A very brilliant question was asked👇

“COPD patient with SpO₂ ~60% presenting with hypertensive emergency, is labetalol still first line?”

Here’s the answer:👇

[Nurse Sarah (RegisteredNurseRN.com) @NursesRN]

Before You Give These Meds, Check these Labs!

Furosemide = Potassium (↓ K+)
Spironolactone = Potassium (↑ K+)
Digoxin = Digoxin level & Potassium (↓ K+ = toxicity)
ACE Inhibitors/ARBs = Creatinine & K+ (↑ K+)
Heparin = aPTT & Platelets
Warfarin = PT/INR
Lithium = Lithium level, Creatinine, Na+ (↓ Na+ = toxicity)
Valproic Acid = LFTs, Platelets, & Drug Level
Phenytoin = Phenytoin Level (10-20 mcg/mL)
Statins = AST/ALT (Liver) & CK (Muscles)
Vancomycin = Trough & Creatinine
Aminoglycosides = Peak/Trough & Creatinine
Metformin = Creatinine/eGFR (Hold for contrast dye!)
Insulin = Glucose
Clozapine = WBC & ANC (Watch for agranulocytosis)
Levothyroxine = TSH (Long-term monitoring)

#nursing #nursingschool #pharmacology

[Internal Medicine @pgMedicine]

Common causes of acute abdominal pain

[RxOfLife💉 @Chiragrx07]

Because Citrate in stored blood products acts as an anticoagulant by binding ionized calcium, potentially causing hypocalcemia that leads to impaired clotting, arrhythmias, and reduced cardiac contractility.

Supplementation with calcium gluconate (often 1g per 3 units of RBCs) helps restore calcium levels, especially during massive transfusions or in patients with impaired citrate metabolism like liver dysfunction or hypothermia.

[Aditya Gupta @DrAditya2935]

Milestones

You can try to read revise and remember them 20 times and you’ll forget them 25 times.

But for gross motor milestones - a simple stick figure can help you figure out everything.

See the stick figure given below. Just remember - 3,6,9,12.

3 months - Neck control
6 months - Trunk control - Sit with Support
9 months - Knee Control - Stand with Support.
12 months - Feet control - walk with support.

A child would be able to stand with support only once it gains ability to sit without support.

So sit without support comes one month earlier - at 8 months.

Similarly- you’ll only be able to walk with support - once you’re able to stand independently.
Hence, stand independently comes at 11-12 months.

In Toto, this becomes

3 - NECK control

6 - Sit with support. (Trunk control)

8 months (9-1) month - Sit without support

9 - Stand with support (knee control)

11 months (12-1) - Stand independently

12 - Walk with support. (Feet control)

That’s it - you’ll now never forget Gross motor milestones for 1st year.