Michael GordonCabeza

Estudiante de Medicina. Salsomano de sangre y amante al deporte.

[Manual Of Medicine @ManualOMedicine]

Types of Aphasia

#medtwitter #foamed #meded

[TA✨ @DrPharmDMDTh]

Diagnosis?

[MEDICINE MADNESS @Doctors_GUILD]

Coffee bean sign is seen in?

a) Gastric volvulus
b) Sigmoid volvulus
c) Hypertrophic pyloric stenosis
d) Midgut volvulus

[Oliverio @LuisOliverio]

La última revisión de hipertensión resistente (JAMA 2026). Puntos clave:

🔴 Hipertensión resistente aparente: Presión arterial de ≥130/80 mm Hg a pesar del uso de 3 o más medicamentos antihipertensivos (IECA o ARA-II, un bloqueador de canales de calcio y un diurético tipo tiazida) a las dosis máximas toleradas. Guías europeas aun dicen ≥140/90.
🔴Hasta 50% de la hipertensión resistente es por mala adherencia. Importante entonces el MAPA y automonitoreo. Mantener sospecha de causas secundarias (hiperaldosteronismo primario o AOS)
🔴Casi un 20% consumen medicamentos que elevan la presión arterial (AINE o ISRS).
🔴Antes de escalar, incluir un IECA o ARA-II, un calcioantagonista y un diurético tiazídico a dosis máximas toleradas.
🔴Añadir espironolactona reduce -13.3 mmHg. No usar si TFG <45, o hiperkalemia. Cuidado con la ginecomastia.
🔴Aunque está en las guías, la denervación renal transcatéter solo disminuye la PAS ambulatoria en un modesto promedio de -4.4 mm Hg. La evidencia no es muy contundente.

Descarga del PDF en el canal (https://t.co/3O93s10lns).

[Manual Of Medicine @ManualOMedicine]

Approach to Elevated Serum Amylase

#medtwitter #foamed #meded

[RADIOLOGISTS @DrAyubaD]

What is the classic incidental findings shown in the left frontal sinus?

Red arrow shows this lesion.

[Ahmed S. A. @guidelinesMed]

In DKA Rx

[The Medics🩺💊💉🏥 @DrArslan480]

Digeorge Syndrome

[Manual Of Medicine @ManualOMedicine]

Diverticular Disease - Complications and Treatment

#medtwitter #foamed #meded

[MEDICINE MADNESS @Doctors_GUILD]

A 3-year-old child presents with barking cough, hoarseness, inspiratory stridor. X-ray shows “steeple sign.”
Diagnosis?

A) Epiglottitis
B) Croup
C) Bronchiolitis
D) Foreign body aspiration

[Keith Siau @drkeithsiau]

You are replaceable at work, but you are NOT replaceable at home. A beautiful and poignant reflection that applies to all clinicians.

[Goles en Directo @golesendir_]

Este James de la Copa América 2024 conducía menos, corría poco, pero era más veloz y mejor jugador que el de 2014.

Es una maravilla.

[JAMA Internal Medicine @JAMAInternalMed]

📌 This Review summarizes the current evidence on the effects of cannabis on commonly encountered mental health conditions and provides clinicians with basic information about cannabis pharmacology and biology.

https://t.co/kYoc7k7O65

[Manual Of Medicine @ManualOMedicine]

Summary of Acid-Base Balance Regulation

#medtwitter #foamed #meded

[nervemed @nervemed]

Updated Tuberculosis Treatment Guidelines

[Dr Kamlesh Darji @DrKamleshDarji1]

Types of giant cells #MedTwitter #PathX

[Abdul Muqtadir Abbasi @AbbasiMuqtadir]

TTP vs HUS

Residents, here you go. Brief cheat sheet to learn TTP vs HUS, role of ADAMTS13 and use of plasmic score.

Save, learn and share.

#MedTwitter
#MedEd
#platelets

[Oren Gottfried, MD @OGdukeneurosurg]

Indications for massive transfusion

[Dr. Filippo Cademartiri @FCademartiri]

🫀🧠 HFpEF is not just “diastolic dysfunction”: the microcirculation is the missing link

This 2025 JACC: Advances state-of-the-art review reframes heart failure with preserved ejection fraction (HFpEF)through a crucial, often underrecognized lens: coronary microvascular dysfunction (CMD) .

📊 How common is CMD in HFpEF? Very.
Up to 75% of HFpEF patients—even without obstructive coronary disease—have CMD. And this is not an innocent bystander:
CMD is independently associated with higher HF hospitalizations
Increased mortality and MACE
Worse quality of life

Yet, CMD is rarely sought and even more rarely diagnosed in routine HFpEF care.

🧠 Why CMD matters pathophysiologically
CMD disrupts the heart at multiple levels:
🔻 Reduced coronary flow reserve (CFR) → subendocardial ischemia
🔥 Microinfarctions & fibrosis → stiff myocardium
⚙️ Impaired cardiac–coronary coupling → blunted flow during stress
🧬 Inflammation & endothelial dysfunction → vicious cycle of ischemia and diastolic failure

HFpEF and CMD reinforce each other in a bidirectional loop, rather than a simple cause–effect relationship.

👩‍⚕️ A sex-specific disease
Women are disproportionately affected:
Higher CMD prevalence
Smaller coronary vessels, higher resting flow
Postmenopausal estrogen loss → inflammation, fibrosis, reduced CFR

This helps explain why HFpEF is more common and more complex in women.

🧪 Diagnosis: we’re under-testing
CMD can be assessed by:
PET or CMR perfusion
Invasive coronary functional testing (CFR, IMR, acetylcholine)

But there is no standardized diagnostic pathway in HFpEF—yet.

💊 Therapy: signals, not solutions
Some treatments show promise (SGLT2i, statins, RAAS modulation, lifestyle, GLP-1/GIP agonists), but no therapy specifically targets CMD in HFpEF so far.

🔮 Bottom line
HFpEF is not only a myocardial disease—it’s a microvascular disease.
If we keep ignoring CMD, we will keep failing HFpEF patients.

👉 Understanding and treating HFpEF may finally require looking beyond the ventricle—into the microcirculation.

[DocXus @docxusofficial]

Skin tells you one story.. eyes confirm it

What is it?