Staci Saunders

Clinician Educator & Hospitalist with @OHSUIMRes. Via @BIDCMRs, @BIDMC_IM and @OHSUSOM | #MedEd | Views my own

[Kirsten Bibbins-Domingo @KBibbinsDomingo]

Just published online first & presented #IDWeek2023

Cefepime vs Piperacillin-Tazobactam in Adults Hospitalized With Acute Infection: The ACORN Randomized Clinical Trial @EdQian @toddrice_ICU & colleagues

https://t.co/xA5SHNamml

[Benjamin E. Ueberroth, M.D. @UeberMD]

Can never review this topic enough - “the water of life” as one of my mentors called 0.9 NS. Fluid choice usually engenders strong opinions, some of my favorite discussions. I’ve always been an #LR guy for general use.

Source: @COREIMpodcast

#MedTwitter

[Casey Kim @caseyjkim]

Why use hydrocort over dex in septic shock? When to prophylax (and for what?) When to stop steroids (and how?)

I had a lot of ??? around steroids which led to this CORE IM episode, which really was a huge team effort given steroids = used for everything

[Elliot Tapper @ebtapper]

I have grown to ❤️IV iron

This is a nice review on the when, why and the how to fill the iron tank

@JosephineCool1 @FreedoBaggins

https://t.co/uvwZCAIaWt

[William Aird @WilliamAird4]

1/10

CASE

76 yo M with Waldenstrom's macroglobulinemia (WM; IgM 3000-5000 mg/dL), treated in past with rituximab, dexamethasone and cytoxan, presents with iron deficiency anemia. Colonoscopy and OGD negative. Capsule study shows multiple jejunal AVMs.

Ring any bells?

[Avraham Z. Cooper, MD 🩺 @AvrahamCooperMD]

1/THREAD
Ever wonder why fluoroquinolones increase the risk of tendon rupture?

It seems so random that a whole class of antibiotics could cause tendon injuries, but the risk is real.

#medtwitter #tweetorial

[Staci Saunders @StaciSaundersMD]

Great framework for rounding

[Avraham Z. Cooper, MD 🩺 @AvrahamCooperMD]

A short 🧵 on my 3️⃣-prong approach to rounding with resident teams in the MICU…

I emphasize 3️⃣ themes to the residents and fellows:

1️⃣ Clinical care
2️⃣ Education
3️⃣ Development

#MedTwitter #MedEd

[William Aird @WilliamAird4]

1/9

Hematologists are comfortable diagnosing and treating Fe deficiency.

However, many of us are outside our comfort zone when it comes to chronic kidney disease.

Why?

Because the diagnostic criteria and indications for treatment are so vastly different, even antithetical.

[William Aird @WilliamAird4]

1/3

Hb or Hct?

I prefer using Hb in patients with anemia because oxygen carrying capacity is limiting, and Hct in patients with polycythemia because blood viscosity is limiting.

For those at equipoise, it's dealer's choice, though I like to think positively and use Hb. 😉

[@X @MoreXGrok]

A 59-year-old woman

👉 had undergone transplantation of the left kidney 16 years earlier for the treatment of polycystic kidney disease

[Staci Saunders @StaciSaundersMD]

Nice review of SGLT2i’s

[Endocrine dialogues @EndoDialogues]

❗️SGLT2i were described a long time ago.

✅They are now popular drugs to treat type 2 diabetes, heart failure, and chronic kidney disease.

Want to know more? Time for a 🧵

1/20

[William Aird @WilliamAird4]

You are seeing a patient with irresistible urge to move legs. How do you go from history to diagnosis?

The diagnostic process involves:

1. Patient representation
2. Diagnostic framework
3. Differential diagnosis
4. Illness scripts

[Tony Breu @tony_breu]

1/14
🤔Why does it take weeks for the radiographic evidence of pneumonia to clear?

Patients often feel better DAYS after starting treatment.

And yet the chest x-ray takes WEEKS to return to normal.

Why the delay?

[Paul Wischmeyer MD @Paul_Wischmeyer]

🙋‍♂️ Best bedside #POCUS & Echo summary I have seen!
#MedEd #MedTwitter #FOAMcc

Thanks to @DocScribbles for this amazing medical art!

[Elliot Tapper @ebtapper]

#livertwitter ALT Bili INR
Normal X X X
Alc hep XX XXX X-XX
Severe injury XXX X-XXX X-XX
ALF XXX XXX >1.5 + HE

[Casey Kim @caseyjkim]

1/4: 🚨 “Do you think it’s ok to give this patient zofran? What about their QTc?” 🚨

#Tweetorial on QT prolonging drugs and torsades de pointes (TdP) 🧵
#MedEd #MedTwitter

[Geoff Stetson, MD @GStetsonMD]

@WrayCharles asks, and he receives (2 years later)!

He asked for a 1-pager to help residents present effective chalk talks. With the help of the inimitable @Gurpreet2015 & @AcadMedJournal, I present to you our humble attempt to fulfill his ask.

Find it👇
https://t.co/ip7JbB2ses

[Clement Lee, MD, MSc @ClementLeeMD]

1/17
When should I send an ammonia? A thread 🧵 and list of indications

#MedTwitter #TipsForNewDocs

[Pulm PEEPs @PulmPEEPs]

It is time for another #RadiologyRounds 🫁 A woman in her mid 40s presents with dyspnea on exertion and the following imaging is obtained.