Akmal Arif

🇵🇸🇲🇾

[🦠 Dr. Ahmed Alanazi @o_o_dr]

Seizure 🧠 ≠ Convulsion ⚡ ≠ Epilepsy

🔵 Seizure: Abnormal brain electrical activity

🔴 Convulsion: Visible shaking movement

🟣 Epilepsy: Recurrent unprovoked seizures

🧠 Pearl: Not every seizure is epilepsy. Not every seizure causes convulsions.

https://t.co/4r50aAuxIN

[Dr RP Singh, MD @rpsingh1894]

Not every microcytic anemia is iron deficiency.

The Mentzer Index remains a useful bedside screening tool:
📌 >13 → IDA
📌 <13 → Thalassemia Trait

Clinical medicine still starts with understanding basics.
#ClinicalMedicine #Hematology #MedicalKnowledge #FOAMed

[𝗦𝗮𝗹𝗲𝗲𝗺 𝗡. 𝗛𝗮𝗺𝗶𝗹𝗮𝗵 🫁 @SaleemHamilah]

Key updates: GINA 2026

💥 One-line Takeaway:
👉 GINA 2026 is less about changing the core strategy and more about refining safety, standardizing acute care, and expanding personalized therapy.

Saleem N. Hamilah

#asthma #asthmamanagement

[Sevda @sevdaloji]

HANTAVİRÜSÜN ERKEN BELİRTİLERİ🚨

Bu belirtiler varsa çok dikkatli olun 🚨

1. “Tuhaf bir grip” gibi başlayan ateş.
+++

[Dr Rupam Manna MD @DrRupamOncology]

🚨 TUMOR LYSIS SYNDROME (TLS) – DIAGNOSIS MASTERCLASS 🔥
High-yield infographic every heme/onc resident & fellow needs:
✅ Cairo-Bishop Classification – Gold standard (Lab TLS + Clinical TLS)
✅ Exact lab cut-offs: Uric acid, K⁺, PO₄³⁻, Ca²⁺ (with 25% change rule)
✅ Pathophysiology correlation (hyperkalemia = most dangerous!)
✅ Risk factors: High burden, Burkitt, venetoclax, etc.
✅ Monitoring (q4–6h labs, ECG, urine) + Exam pearls
Early recognition = Prevent AKI & save lives
Cairo-Bishop = standard diagnostic criteria
Save this for wards, boards & night calls 📌
Tag a co-resident/fellow who rotates on heme/onc 👇
RT if this just became your new TLS bible!
#TLS #TumorLysisSyndrome #MedEd #HemeOnc #Oncology #MedTwitter #FOAMed #Cancer

[Nurse + @Nurseplus7]

Fluids of Choice

[Dr.Marlon Villanueva™ 🩺 𝕏 @MarlonVFZR]

🫁𝗩𝗲𝗻𝘁𝗶𝗹𝗮𝗰𝗶𝗼́𝗻 𝗺𝗲𝗰𝗮́𝗻𝗶𝗰𝗮: 𝗥𝗲𝘀𝘂𝗺𝗲𝗻📑
⬇️⬇️⬇️⬇️

🚨 ¿𝘾𝙪𝙖́𝙣𝙙𝙤 𝙞𝙣𝙩𝙪𝙗𝙖𝙧?

* 🫁 Hipoxemia refractaria
* 🌬️ Hipercapnia + acidosis
* 😮‍💨 Fatiga respiratoria
* 🧠 ↓ conciencia

👉 𝙉𝙤 𝙚𝙨 𝙪𝙣 𝙥𝙧𝙤𝙘𝙚𝙙𝙞𝙢𝙞𝙚𝙣𝙩𝙤, 𝙚𝙨 𝙪𝙣𝙖 𝙙𝙚𝙘𝙞𝙨𝙞𝙤́𝙣 𝙛𝙞𝙨𝙞𝙤𝙡𝙤́𝙜𝙞𝙘𝙖

⚙️ 𝙍𝙚𝙜𝙡𝙖 𝙙𝙚 𝙤𝙧𝙤

* 🫁 Oxigenación = 𝙁𝙞𝙊₂ + 𝙋𝙀𝙀𝙋
* 🌬️ Ventilación = 𝙁𝙍 + 𝙑𝙏

❌ Error clásico: subir FiO₂ en hipercapnia

🧠 𝙋𝙪𝙡𝙢𝙤́𝙣 𝙚𝙣 𝙎𝘿𝙍𝘼

* 🧱 ↓ compliance
* 🔀 Shunt
* 💀 Lesión inducida por ventilador

👉 Estrategia:

* 📉 VT bajo (6 ml/kg)
* ⬆️ PEEP
* ⚖️ Hipercapnia permisiva

⚠️ 𝙇𝙤 𝙦𝙪𝙚 𝙢𝙖𝙩𝙖

* 💥 Barotrauma
* 🫁 Volutrauma
* 🦠 VAP
* 🫀 ↓ retorno venoso → shock

🔥 𝙈𝙚𝙣𝙨𝙖𝙟𝙚 𝙘𝙡𝙖𝙫𝙚
👉 El ventilador no “mejora” al paciente…
👉 𝙖𝙢𝙥𝙡𝙞𝙛𝙞𝙘𝙖 𝙩𝙪 𝙚𝙨𝙩𝙧𝙖𝙩𝙚𝙜𝙞𝙖: 𝙥𝙪𝙚𝙙𝙚 𝙨𝙖𝙡𝙫𝙖𝙧𝙡𝙤 𝙤 𝙙𝙚𝙨𝙩𝙧𝙪𝙞𝙧 𝙨𝙪 𝙥𝙪𝙡𝙢𝙤́𝙣 𝙚𝙣 𝙝𝙤𝙧𝙖𝙨

🧠𝙂𝙪𝙖𝙧𝙙𝙖 𝙚𝙨𝙩𝙚 𝙝𝙞𝙡𝙤 𝙥𝙖𝙧𝙖 𝙩𝙪 𝙜𝙪𝙖𝙧𝙙𝙞𝙖 🏥

‼️Si te sirve: ❤️ Me gusta | 🔁 Repost | ➕ Follow para más #MedED en #ClubCrit 😄🧠🫶

👇🏼👇🏼👇🏼👇🏼
📚📖#ClubCrit

#MechanicalVentilation #icu #intensivecare #diagnosis #POCUS #VExUS #management #MedicinaBasadaEnEvidencia #Terapia #MedEd #Medicina #FOAMed #FOAMcc #CuidadoCrítico #MedX #EducaciónMédica #MedIntensiva #MedXCommunity #MedicinaCrítica #MedED #CritCare #ICUManagement #MustRead #LecturaRecomendada

[Dr.Marlon Villanueva™ 🩺 𝕏 @MarlonVFZR]

🫀🫁 𝗣𝗢𝗖𝗨𝗦 𝗱𝗲 𝗰𝗼𝗻𝗴𝗲𝘀𝘁𝗶𝗼́𝗻: 𝘃𝗲𝗿 𝗺𝗮́𝘀 𝗮𝗹𝗹𝗮́ 𝗱𝗲𝗹 𝗲𝗱𝗲𝗺𝗮 𝗽𝘂𝗹𝗺𝗼𝗻𝗮𝗿
⬇️⬇️⬇️⬇️

🔍 𝙀𝙫𝙖𝙡𝙪𝙖𝙘𝙞𝙤́𝙣 𝙞𝙣𝙩𝙚𝙜𝙧𝙖𝙙𝙖 (𝟰 𝙙𝙤𝙢𝙞𝙣𝙞𝙤𝙨)

1. 🫁 𝙋𝙪𝙡𝙢𝙤́𝙣 (𝙡𝙞́𝙣𝙚𝙖𝙨 𝘽)
* Distribución bilateral → congestión intersticial
* Gradiente → leve / moderada / severa
2. 🫗 𝙑𝙚𝙣𝙖 𝙘𝙖𝙫𝙖 𝙞𝙣𝙛𝙚𝙧𝙞𝙤𝙧 (𝙑𝘾𝙄)
* 📏 Diámetro + colapso → estimación de presión auricular derecha
* ⚠️ Dilatada + poco colapso = congestión sistémica
3. 🩸 𝙑𝙚𝙣𝙖𝙨 𝙝𝙚𝙥𝙖́𝙩𝙞𝙘𝙖𝙨
* Normal: 𝙎 > 𝘿
* Congestión: 𝙎 < 𝘿
* Grave: 𝙧𝙚𝙫𝙚𝙧𝙨𝙤 𝙨𝙞𝙨𝙩𝙤́𝙡𝙞𝙘𝙤 (𝙎 𝙞𝙣𝙫𝙚𝙧𝙩𝙞𝙙𝙖)
4. 🟤 𝙑𝙚𝙣𝙖 𝙥𝙤𝙧𝙩𝙖
* Normal: flujo continuo
* Congestión: pulsatilidad ↑
* Grave: pulsatilidad >50%
5. 🧬 𝙑𝙚𝙣𝙖𝙨 𝙞𝙣𝙩𝙧𝙖𝙧𝙧𝙚𝙣𝙖𝙡𝙚𝙨
* Normal: flujo continuo
* Congestión: patrón bifásico
* Grave: patrón monofásico

📊 𝘾𝙡𝙖𝙨𝙞𝙛𝙞𝙘𝙖𝙘𝙞𝙤́𝙣 𝙥𝙧𝙖́𝙘𝙩𝙞𝙘𝙖

* 🟢 𝙎𝙞𝙣 𝙘𝙤𝙣𝙜𝙚𝙨𝙩𝙞𝙤́𝙣
* 🟡 𝘾𝙤𝙣𝙜𝙚𝙨𝙩𝙞𝙤́𝙣 𝙡𝙚𝙫𝙚
* 🔴 𝘾𝙤𝙣𝙜𝙚𝙨𝙩𝙞𝙤́𝙣 𝙨𝙚𝙫𝙚𝙧𝙖 (𝙑𝙀𝙭𝙐𝙎 𝙖𝙡𝙩𝙤)
* VCI dilatada + alteraciones Doppler severas

🚨 Mensaje clave

👉 El edema pulmonar te dice que el problema ya ocurrió, pero el Doppler venoso te dice 𝙘𝙪𝙖́𝙣𝙩𝙤 𝙙𝙖𝙣̃𝙤 𝙚𝙨𝙩𝙖́ 𝙝𝙖𝙘𝙞𝙚𝙣𝙙𝙤 𝙖𝙝𝙤𝙧𝙖

👉 Una VCI dilatada no es el diagnóstico
es solo la puerta de entrada

👉 La verdadera congestión se confirma cuando
el pulso cardíaco invade territorios venosos

👉 Si no miras hígado, porta y riñón
estás subestimando la congestión… y tratando a ciegas

🧠𝙂𝙪𝙖𝙧𝙙𝙖 𝙚𝙨𝙩𝙚 𝙝𝙞𝙡𝙤 𝙥𝙖𝙧𝙖 𝙩𝙪 𝙜𝙪𝙖𝙧𝙙𝙞𝙖 🏥

‼️Si te sirve: ❤️ Me gusta | 🔁 Repost | ➕ Follow para más #MedED en #ClubCrit 😄🧠🫶

👇🏼👇🏼👇🏼👇🏼
📚📖#ClubCrit

#POCUS #VExUS #icu #intensivecare #diagnosis #management #MedicinaBasadaEnEvidencia #Terapia #MedEd #Medicina #FOAMed #FOAMcc #CuidadoCrítico #MedX #EducaciónMédica #MedIntensiva #MedXCommunity #MedicinaCrítica #MedED #CritCare #ICUManagement #MustRead #LecturaRecomendada

[Ahmed Al Askary @a_elaskary81]

DKA 2026

https://t.co/suYhpZ5gXn

[MEDICINE MADNESS @Doctors_GUILD]

Stepwise management of status epilepticus

Patient with seizure ≥ 5 minutes
│

Stabilize ABC
• Airway
• Oxygen
• IV access
• Check glucose
│

STEP 1: Benzodiazepine (First-line)
• Lorazepam IV
OR
• Diazepam IV
│

STEP 2: Long-acting Antiepileptic
• Phenytoin / Fosphenytoin
│

STEP 3: If seizure persists
• Phenobarbitone
│

REFRACTORY STATUS EPILEPTICUS
• Propofol infusion
• Midazolam infusion
• ICU management

[The Medics🩺💊💉🏥 @DrArslan480]

SIDS

[سامي @smahup1]

Important clinical signs

[AbdAllah Othman @CardioBeat_]

https://t.co/nPptWFSAQK
ECG leads and coronary anatomy.
🫀 II, III, aVF → RCA
🫀 V1–V4 → LAD
🫀 I, aVL, V5–V6 → LCX
🫀 V7–V9 → RCA or LCX
Like | 📤 Share | 👥 Tag a colleague | ⏳ Save for later. 🤗
#Cardiology #ECG #EKG #STEMI #MI #HeartAttack #MedicalEducation #MedStudent

[It's Amey 𝕏 @ameydeen_]

“Confident Sembang, Tapi Fakta Ke Laut”

Begini dik.

Biar abang sekolahkan adik mengenai sedikit sebanyak perihal industri minyak negara kita.

1. Malaysia ni negara pengeluar minyak.

2. Walaupun Malaysia menjual minyak kepada negara lain, dalam masa yang sama..

🧵

[KONGSI VIRAL🇲🇾 @kongsiviralje]

Tahu tak?

Setiap malam dalam Bulan Ramadan, Allah bebaskan 60,000 nama dari menjadi penghuni neraka.

Jadi, mohonlah doa ini sebelum berbuka..

[MYNEWSHUB @mynewshub]

Seorang lelaki warga emas dari Mesir memasuki sebuah farmasi untuk membeli ubat.

Namun apabila dimaklumkan bahawa ubat tersebut tidak tersedia, dia tidak merungut atau marah.

Sebaliknya, dia secara tiba-tiba melakukan gulingan (somersault) di dalam farmasi sebelum berjalan keluar dengan tenang.

Ahli farmasi itu menyifatkan kejadian berkenaan sebagai reaksi paling pelik yang pernah disaksikannya.

[Akmal Arif @_akmalarif]

Refer surgry harini :-

“Takpa satgi saya mai”
Tk sampai lima minit terus dtg❤️❤️

[سامي @smahup1]

UTI ( urinary tract infections)

[Akmal Arif @_akmalarif]

Mmg hari paeds surg harini😍😍