Adarsh

Sculpted in UCMS, Delhi ||
being chiseled as a general surgeon 🗡🔪 in MAMC delhi

[Dr. Praveen Tripathi @drpraveenpsy]

How sick this journalist is? He wants a doctor to get kicked and accept it as his fate.
Dear Residents, you have every right to safeguard your life. Vultures like this journalist would try to make you believe that as doctors you are meant to take blows without responding. Dont fall for it

[Adarsh @KumarAd23189942]

@Indian__doctor The audacity of politicians 🤡
"Beta apna kaam nikalo" is what I have been said repeatedly by my parents. I understand they care for me and that's why they say this. But this attitude is taking the country to drains

[Adarsh @KumarAd23189942]

Cancer is the Trojan horse creeping in as an innocent symptom

[Dr Abhilasha Manwatkar (AIIMS Nagpur) @Abhilasha21822]

New joint pain + clubbing = search for cancer.

Why ..let’s decode👮🏾🕵🏽‍♀️

A 60-year-old man came with history of 8 weeks of joint pain.
Also mentions breathlessness + dry cough. Hands show clubbing.

X-ray shows periosteal new bone formation and tram-line sign.

But CT chest changes everything...

👉 Diagnosis is easy : Hypertrophic osteoarthropathy (HOA)

How do you diagnose HOA? 🦴🫁
🔹 Arthralgia/synovitis
🔹 Bone pain (tibia & femur classic)
🔹 Digital clubbing
🔹 X-ray: periostitis / tram lines
🔹 Always image the chest

Till here it’s easy twist is…
Why we did chest xray and ct thorax …

⚠️ New-onset HOA = think malignancy until proven otherwise

Key pearl 💡
📊 new onset means secondary HOA can be due to an underlying malignancy
📍 Most commonly lung cancer (NSCLC)..

Take-home
Rarely Joint pain may be the first sign of cancer.
Always 👀 beyond joints…

[Adarsh @KumarAd23189942]

@PJaseja I'll take a guess. CLD? Since urea Kam banayega liver?

[Adarsh @KumarAd23189942]

Failing kidney is not the only thing which can raise BUN

[Ryan O'Keefe @ROKeefeMD]

Daily Pearl:

Cocaine can cause profound ischemia due to severe vasoconstriction, leading to rare catastrophes like acute necrotizing esophagitis.

A BUN level >100 (in this case it was 173!) should raise suspicion for a massive upper GI bleed.

“Black esophagus” is a rare endoscopic finding that signals critical illness a very high mortality rate.

Source: CPS - October 15, 2025 VMR with Sharmin & Kuchal - withdrawal symptoms

[Adarsh @KumarAd23189942]

@DocPriyamMD Hi sir.
Verified account nhi hai but the person behind is trustworthy for sure 🥲

[Adarsh @KumarAd23189942]

@KrutiPatel2000 Joining to Kal se hai na lekin?🙂

[Nirmal Pandey MD DM Neurologist @nirmalregency]

‼️Never experienced 👇 before
68♂ Obese
Acute Stroke. LWK 2 hrs
Rt hemiparesis + aphasia
TNK bolus 💉
After 30 min➡️acute upper airway obstruction
ET tube ❌ be negotiated.
Urgent tracheostomy performed 👇

[Adarsh @KumarAd23189942]

@drkeithsiau Had similar finding in a patient. She was around 50 years. Ordered usg to rule out AAA. Came negative. Then Ordered cect. Again no AAA. But it revealed a mass in ileo cecal region. Patient later revealed she had black stools.

Unfortunately, lost the patient to follow up!

[Aditya Gupta @DrAditya2935]

During my internship in Pediatrics - during rounds the Professor asked a question - I knew the answer while residents didn’t.

The Professor just said that it’s okay to have developmental regression during residency to the residents. The work pressure doesn’t allow much time for study. It was part taunt but part consolation that he understood their predicament (work vs study)

2y later - me as resident- same Professor- exact same situation- an intern answered - while we couldn’t .

Professor remembered and told me - Congrats Aditya - Your development regression is now complete :)

Two years! He remembered and the callback to the OG joke took two year! 😅

[Adarsh @KumarAd23189942]

@Arron_Pearce_ Yes 🙂
Atrial flutter?

[Adarsh @KumarAd23189942]

@DocPriyamMD Takayasu arteritis?
Supra valvular AS?
Aortic dissection?

[Adarsh @KumarAd23189942]

@DrKamleshDarji1 Was never great with slides but I think I should take a guess. Spindle cells along with capillaries?
GIST?
Leiomyoma?

[Adarsh @KumarAd23189942]

@danatsouza

[Adarsh @KumarAd23189942]

@DocPriyamMD Cholesterol gallstones being removed after cholecystectomy?

[Adarsh @KumarAd23189942]

1. Sir could it be sle flare causing encephalitis and myositis?
2. Or unrelated seizures with cpk rise due to drugs used during icu management?
3. Or an infection causing encephalitis complicating as seizures.
4. Cpk rise can also be due to intense muscle activity and damage during seizure episode

[Dr.Priyanshu Jaseja @PJaseja]

@Abhilasha21822 A: Accident and trauma... Seizures here!!

[Adarsh @KumarAd23189942]

1. Sir could it be sle flare causing encephalitis and myositis?
2. Or unrelated seizures with cpk rise due to drugs used during icu management?
3. Or an infection causing encephalitis complicating as seizures.
4. Cpk rise can also be due to intense muscle activity and damage during seizure episode

[Aravind Palraj @Rheumat_Aravind]

Not every “septic” patient has infection.

Severe acidosis? Check ketones.
Fever + AF with extreme tachycardia? Think thyroid storm.
Shock + abdominal pain? CTA early.

Sepsis mimics steal time. Pattern recognition gives it back.

#InternalMedicine #EmergencyMedicine @DrAkhilX @IhabFathiSulima #CriticalCare #MedicalEducation

[Aravind Palraj @Rheumat_Aravind]

Not every patient with fever, hypotension, and lactate has sepsis.

When there’s no clear source, think again:
PE. Adrenal crisis. Pancreatitis.

Missing the mimic costs time.

#InternalMedicine #EmergencyMedicine #CriticalCare #MedicalEducation @DrAkhilX @IhabFathiSulima @DrNikhilMD

[Adarsh @KumarAd23189942]

@dr_rmdofficial @PhysicswallahAP Haven't watched the video and don't know the exact scenario but In my humble opinion , I don't think addressing someone as "sir" is considered being inferior