Terry Shaneyfelt

Clinician-educator at UAB School of Medicine. My teaching interests revolve around EBM and educational technology. Any views expressed here are mine.

[Robert Centor MD MACP 🇮🇱 @medrants]

Continuing CKD for internists and house staff

When the Kidney Can’t Keep Up: Mineral Metabolism, Acid-Base, and Anemia in Progressive CKD https://t.co/9ulngN5IbB

[William Aird @WilliamAird4]

ANEMIA CLASSIFICATION

[William Aird @WilliamAird4]

CIRRHOSIS AND BLOOD

Cirrhosis is not just a “liver problem.”

It affects the whole hematologic system:

RBCs → target cells, spur cells
WBCs → leukopenia
Platelets → thrombocytopenia
Coagulation → not simply “auto-anticoagulated”

[Terry Shaneyfelt @EBMTeacher]

@kidney_boy Its worse to have than spell. I can't hear out of 1 ear and I'm amazed I didnt get injured with the horrible vertigo that would hit me out of the blue.

[Bishal Gyawali, MD, PhD, FASCO @oncology_bg]

A MUST-READ!

This is probably one of my most important papers where I try to teach how to fish rather than offer fish.

How I Read a Clinical Trial Report?

BG’s primer for Busy Clinicians.

Thank you @JCOOP_ASCO @EthicsdoctorP for the kind invitation. I hope the readers will find this useful.

https://t.co/HJhZlsBpU2

[William Aird @WilliamAird4]

APPROACH TO ANEMIA

Most anemia algorithms start with the MCV.

That’s a mistake.

The first branch point is the reticulocyte count.

It asks a physiological question:
Is the marrow responding?

MCV describes appearance.
Reticulocytes reveal function.

[Cory Rohlfsen @CoryRohlfsen]

🚨Pub alert ‼️

Diagnostic reasoning is hard in practice but even tougher to teach. We created an organizing framework that can help: the 5Ls

@VipsMDMEd @JamesBowenMD @andrewparsonsMD @shuhanhemd @YihanYangMD @CaseyMcQuadeMD @rabihmgeha @AnandJag1

https://t.co/aWQwFakZAy

[Cory Rohlfsen @CoryRohlfsen]

Today I led AM Report & learned that tx of #methemoglobinemia in pts w/ #G6PDdeficiency should be w/ vitamin C since methylene blue requires NAPDH as a reducing agent (scarce in G6PD def).

@ASanchez_PS @ercowboy @doc_BLocke @jasonryanmd @ROKeefeMD @allisonoconn @grepmeded

[Edgar V. Lerma 🇵🇭 @edgarvlermamd]

Flowsheet for the potential escalation of diuretics in patients with refractory hypervolemia
#Nephpearls #Cardiorenal

👉 https://t.co/4mvwuYf8P2

[William Aird @WilliamAird4]

1/11

I posted a poll:

A woman with ferritin 10 and Hb 12.2 (baseline 14). How should this be described?

Here’s how you answered:

• non-anemic Fe deficiency: 35%
• Fe deficiency anemia: 32%
• Fe deficiency with relative anemia: 27%
• none: 6%

Really interesting spread!

[Cory Rohlfsen @CoryRohlfsen]

Family history is important.

3 most missed diagnoses in #primarycare due to lapses in FHx:

1) familial hypercholesterol (1:250)
2) celiac disease (1:100)
3) breast / ovarian ca (1:150 BRCA)

These base rates are general population & ⬆️ 2-10x if ➕FHx

All modifiable risk

1/4

[Anil Makam @AnilMakam]

Rapid fire summary posted here

https://t.co/hrAdDoDrQJ

[Terry Shaneyfelt @EBMTeacher]

@RedEagleUpdates Who's reading this garbage? He doesn't remeber anything to give a memoir

[CardiovascularCorner @TrackYourHeart]

Interpreting an #ECG can seem overwhelming at first, but with a structured approach, it becomes far more manageable.

In this thread, I’ll walk you through how to analyze an ECG like a professional, step by step.

Let’s begin.🧵

[Terry Shaneyfelt @EBMTeacher]

@elonmusk Swift punishment is needed. Not 20 to 30 yrs later. And on tv so it becomes a deterrent. Pay per view. Could fund the legal system

[Adam Grant @AdamMGrant]

It's time to remove laptops from classrooms.

24 experiments: Students learn more and get better grades after taking notes by hand than typing. It's not just because they're less distracted—writing enables deeper processing and more images.

The pen is mightier than the keyboard.

[NEJM @NEJM]

Presented at #SVIN25:

CREST-2: In high-grade asymptomatic carotid stenosis, addition of stenting to medical therapy led to a lower risk of stroke over a 4-year period. Endarterectomy did not lead to a significant benefit. Full results: https://t.co/ojge1CjqiU

Editorial: Managing Asymptomatic Carotid Stenosis https://t.co/D9LH89Edyk

@svinsociety

[Terry Shaneyfelt @EBMTeacher]

@DrPharmDMDTh @EM_RESUS Myocardial contusion...can't infarction every single vascular territory

[Sanjeev Sethi @SethiRenalPath]

Glomerular disease made simple:

The location of injury➡️ dictates pattern of injury➡️points to etiology (based on immunofluorescence) ➡️ and results in a specific clinical syndrome.

Study this figure carefully & you will understand the basics of GN.

https://t.co/aGD0K0htNV

[JAMA @JAMA_current]

Clinicians can enhance patient understanding by using numerical data instead of verbal probabilities, consistent denominators, absolute risk comparisons, and clear context for unfamiliar data types.

https://t.co/1cAtzXCbSn