Bruce Wayne Parody

Princeton Student
Prince of Gotham
Gotham Knights fan 🏈
Not Batman.
" Rich jerk according to some. "
#DCRP
(Following, RTs, links, and likes ≠ endorsement.)

[Bruce Wayne Parody @Knight47Wayne]

" I seek … the means to fight injustice. To turn fear against those who prey on the fearful."

https://t.co/oMKdTzMBzj
#DCRP

[د. وعــــد الـحـربــي @promisealharbi2]

حلو تكون familiar مع الاسامي بعضهم يجي من برا صارفها ويسالك عنها

[Aravind Palraj @Rheumat_Aravind]

GPA, MPA, and EGPA can all present as ANCA-associated vasculitis—but the clinical phenotype often tells you where to look.

GPA → destructive ENT disease + pulmonary nodules/cavitation + GN
MPA → RPGN + pulmonary capillaritis/DAH, without granulomatous ENT disease
EGPA → asthma + eosinophilia + neuropathy; ANCA status often tracks phenotype

The overlap is real. The pattern is the clue.

#Vasculitis #Rheumatology #AAV #ANCA #MedEd @IhabFathiSulima @docakx

[Manual Of Medicine @ManualOMedicine]

Interpretation of Bilirubin Levels

#medtwitter #foamed #usmle

[William A. Wallace, Ph.D. @WilliamWallace]

Every nerve in your body is wrapped in myelin, a multilayered lipid sheath that insulates the axon and lets electrical signals travel fast. B12 maintains this sheath through two separate pathways, and both fail at the same time when B12 drops.

The first pathway runs through methionine synthase. B12 (as methylcobalamin) converts homocysteine into methionine, which becomes SAMe. SAMe provides the methyl groups needed to build phosphatidylcholine, one of myelin's major lipid components. When B12 is low, SAMe drops and myelin lipid synthesis stalls.

The second pathway runs through methylmalonyl-CoA mutase. B12 (as adenosylcobalamin) clears methylmalonyl-CoA by converting it to succinyl-CoA. Without B12, methylmalonic acid (MMA) accumulates and abnormal fatty acids get incorporated into the myelin sheath itself, weakening its structure from the inside.

What makes this dangerous: the nerve damage can appear before anemia does. In the Lindenbaum NEJM study, 28% of patients with neuropsychiatric symptoms from B12 deficiency had completely normal blood counts. No anemia, no macrocytosis. The myelin was already degrading with nothing on the CBC to flag it. If caught early, repletion can reverse it. If caught late, the demyelination can become permanent.

Scalabrino, Prog Neurobiol, 2009.
Lindenbaum et al., NEJM, 1988.

[Bruce Wayne Parody @Knight47Wayne]

@alisoncook Pathological Alterurism. " Mercy to the guilty is cruelty to the innocent"

[Bruce Wayne Parody @Knight47Wayne]

@ifonlyiwasnaive " Gorgeous."

[Bruce Wayne Parody @Knight47Wayne]

@soulfulsonata " Quite exquisite. "

[Bruce Wayne Parody @Knight47Wayne]

#sexysaturday

[Bruce Wayne Parody @Knight47Wayne]

@soulfulsonata " I'm good, why are you sad?"

[Bruce Wayne Parody @Knight47Wayne]

@soulfulsonata " How are you?"

[U.S. Air Force @usairforce]

78 years of airpower — fueled by Airmen who #FlyFightWin!

Salute the past and celebrate the future us.

#AirForceBirthday

[Bruce Wayne Parody @Knight47Wayne]

@soulfulsonata // Well you do have great vibes.

[Bruce Wayne Parody @Knight47Wayne]

@rickygervais You roasting them is the only enjoyable part of any awards show.

[Bruce Wayne Parody @Knight47Wayne]

#SexySaturday

[Bruce Wayne Parody @Knight47Wayne]

#SeductiveSunday

[Bruce Wayne Parody @Knight47Wayne]

#SeductiveSunday

[Bruce Wayne Parody @Knight47Wayne]

@SupergirlZorEl " Any time, Miss Kent."