G S

htttp://www.twitch.tv/liquidbear

[G S @DemonHun7er]

@luxemiaa It's baffling how many people are missing the point of this post...

[Ashley Miller @icmteaching]

1/
Most people think the heart drives circulation.
But what if that’s backwards?
Anderson’s model flips the whole idea of cardiac output on its head — and it changes how you think about fluid, flow, and failure.
🧵👇
#physiology #FOAMed #MedTwitter #criticalCare #cardiacOutput

[G S @DemonHun7er]

@unhealthytruth 3 COVID shots. Got it 0 times. Even though I was a resident for almost 9 months in a COVID ward.

[Nick Mark MD @nickmmark]

@Gandulf_da_Grey Low inspired oxygen
Alveolar hypoventilation
V/Q mismatch
Shunt
Diffusion limitation
Low mixed venous oxygen

[Mark Dolan @mrmarkdolan]

When you abandon excellence and merit, look what happens 🥳

[Turning the Tide @Turningthe_Tide]

🧵Why does low protein intake cause hyponatraemia?

Most people find this confusing.

But the underlying physiology is beautifully simple.

Let’s walk through it 👇

#Hyponatraemia #FluidBalance #MedTwitter #FOAMed

[Yüksel Ürün @DrYukselUrun]

BREAKING from @NEJM
In cancer patients w/ Cancer-Associated Venous Thromboembolism, reduced-dose apixaban (2.5 mg BID) is :
🔘Noninferior to full-dose (5 mg BID) for VTE recurrence
🔘Lower bleeding risk (12.1% vs. 15.6%)
🔘Safer extended anticoagulation, same protection.
#Thrombosis #cancer @OncoAlert @Cihan_Ay_MD
DOI: 10.1056/NEJMoa2416112

[Ross Prager @ross_prager]

Lasix is NOT nephrotoxic 🫘

Please retweet so we can end this myth once and for all 🦄

Rising creatinine is more often an indicator of inadequate Lasix dosing than excessive!!

Lasix can only harm the kidneys if it decreases cardiac output by dropping preload to the point of reducing stroke volume... as someone who scans these patients regularly this is surprisingly rare!

If a patient still has venous congestion (on Doppler), then Lasix is not driving the AKI. Instead, their AKI is from untreated congestion!!

[Keith Siau @drkeithsiau]

Cross-sectional anatomy of a kidney 🫘

[Ross Prager @ross_prager]

(1/x) We care about STEMI on ECG because it suggests 'Occlusive Myocardial Infarctions' (MIs that completely block a coronary artery)

But... there are other ECG patterns that suggest complete coronary occlusion

A 🧵on can't miss ECG patterns.

[G S @DemonHun7er]

@interesting_aIl It feels like the soundtrack of a Super Mario game on a underwater level.

[The PhD Place @ThePhDPlace]

Academia is deeply flawed

[Ross Prager @ross_prager]

I hear clinicians say the physical exam is dead.☠️ This is just not true 🛑

Here are the 10 most important clinical exam findings in the ICU

A 🧵

(and some things you can probably stop doing...)

#medtwitter #foamed

[G S @DemonHun7er]

@mikyx I am so sorry, Miky. Best of luck next year. :(

[G S @DemonHun7er]

@FloridaMan_20 @TheCriticalDri2 Who is she?

[iamyesyouareno @iamyesyouareno]

Russia made a propaganda video about a Russian couple moving to the US.

But can you still call it propaganda if it is 100% accurate?

[PHD Comics @PHDcomics]

Academic rejection

[Prof Lennart Nacke, PhD @acagamic]

Stop staring at a blank page.

• Abstract: Rationale, methods, results, implication
• Intro: Context, problem, hypothesis
• Methods: Design, subjects, measures
• Results: Data, figures, observations
• Discussion: Interpret results, compare studies

Write with confidence.

[Ross Prager @ross_prager]

(1/x) The inferior vena cava (IVC) is 'useless' is a phrase stated confidently and incorrectly by #pocus novices. ❌

The IVC is useless at:
- telling you what to eat for dinner
- acting as a fuel gauge for volume status
- predicting fluid responsiveness

HOWEVER.

The IVC is incredibly useful in helping us decide on the optimal fluid and decongestion strategy for your patients.

A 🧵

(With a bonus discussion of future of #VEXUS research at the end. )

#medtwitter #foamed #echofirst

[@X @MoreXGrok]

Know the abnormal arterial pulsations and the disease state with which they are commonly associated.