DrBK

Faculty in internal medicine at Carolinas Medical Center. World citizen. POCUS enthusiast. Tweets do not equal advice. He/him/his.

[Sam Ghali, M.D. @EM_RESUS]

Hi, ER Doc here.

RT if you’ve ever done CPR on someone and they survived.

Trying to prove something.

[Anti MD MD Club @HMhnuey]

Where is your God now? Has he forsaken you?

[Ria Dancel, MD @ria_dancel]

Beware the peak of the Dunning Kruger curve! Exposure to #POCUS leading to overconfidence and poor clinical integration can lead to patient harm.

[Stella Safo, MD MPH @AmmahStarr]

Please read this twice, fellow docs. Terms like ‘non-complaint’ and ‘against medical advice’ pigeonhole already marginalized patients and can literally contribute to adverse outcomes. We need to do better.

[Sagar Nigwekar @sagarnigs]

New publication from our group. Severe Hyponatremia Correction, Mortality, and Central Pontine Myelinolysis | NEJM Evidence https://t.co/99sk3rhAPW @ASNKidney

[Dad Jokes @Dadsaysjokes]

An epidemiologist, a scientist and a doctor walk into a bar...

...just kidding, they know better.

[Manoj Wickramasinghe @manoj-w.bsky.social @Manoj_Wickram]

Echo is one of the more skilled ultrasound exams you can do. Having learnt it and now teaching it, I see the same mistakes being made over and over again. I have put together thread on beginner mistakes in echo. #tweetorial #POCUS #FUSIC #askpocus

[Adam Rodman @AdamRodmanMD]

Today @AvrahamCooperMD and my essay on AI/LLMs and medical education comes out in @NEJM , about the challenges our field faces and what we should do about it.

I wanted to give some context for this essay, and talk about some of the things we can be doing NOW.

A brief 🧵⬇️

[DrBK @DRBK_EDU]

@CMC_IM

[DrBK @DRBK_EDU]

@CMC_IM I have a guess!

[DrBK @DRBK_EDU]

@DxRxEdu Much better than mine. It can also do a great job making frameworks into mnemonics if that’s your thing. I had it make a framework for adult onset tremor and then asked it to suggest some.

[Guido Meijer @guido_meijer]

I was watching Lord of the Rings last night and realized there are many parallels with academia!

A thread 🧵👇

[CMC IM Residency @CMC_IM]

Our first TNR of the year:

67M s/p OLT (2022) for HCC with recent recurrence now on lenvatinib, known PFO presents with 2wks worsening of dyspnea on exertion.

What’s your approach to this patient?

Tune in later for the reveal!

#FOAMED #internalmedicine #CMCIM

[POCUS Med Ed @pocusmeded]

Reason #56786 why #pocus is important: chest x-rays are not sensitive enough, especially in the setting of other cardiopulmonary disease.

Middle aged man with recent ablation presented to the hospital with tachycardia, hypotension and cough.

Initial chest X-ray:

[DrBK @DRBK_EDU]

@nikdes13 @PaulNWilliamz Great question. I try to do exactly what I would in the clinic as next step. If not my patient, probably more reluctant to start full agonists (and I’m pretty reluctant at baseline). Depending who pcp is and their comfort, may be less reluctant to start some low dose bup.

[Adam Rodman @AdamRodmanMD]

Can GPT-4 solve really hard medical cases and come up with a good list of differential diagnoses?

@zahirkanjee @byrondcrowe and my study is out in @JAMA_current , and the short answer is, “Yes.”

But what does this all mean? 🧵⬇️ https://t.co/Jn4ojzmXHd

[Joel M. Topf, MD FACP @kidney_boy]

Reading applications for fellowship I see a lot of personal statements. Most are about as spicy as white rice. But this sentence...😍

[DrBK @DRBK_EDU]

Would also note that this case highlights the importance of putting a probe on someone’s chest before deciding on ICU vs floor status even after you know about the PE.

[IMCrit @IM_Crit_]

Take-home message:
A patient can have huge PE clot burden WITHOUT hypotension or hypoxemia. Ruling out PE on the basis of "normal O2 sat and BP" can have dire consequences...

[Rahul Ganatra @rbganatra]

1/
A patient receiving his first-ever dose of IV Iron (ferumoxytol) suddenly develops diffuse face & trunk flushing, chest pain, myalgias, and anxiety.

Blood pressure is normal and lungs are clear.

You are called to the bedside to assess.

How likely is anaphylaxis?