Marcus Muñoz

ID Fellow at UCLA - Formerly @uclaimchiefs Chief Resident - @IowaMed Carver College of Medicine ‘21 - @Stanford ‘15

[Elisabeth Potter MD @EPotterMD]

I stepped out of a new patient’s consult to have this peer to peer call at the only time offered to me. You may remember an insurance company recently insisting that they’d never interrupt patient care for insurance matters. Reality Check…it happens all the time.

The doctor I spoke with was a general surgeon who had never performed breast reconstruction. He declined to give me his name, citing concerns for his personal safety. He was polite, but ultimately told me that United considers nerve sparing mastectomies “experimental”. He would not provide a written rationale or references for the studies used to make this determination.

But he kindly invited me to appeal.

Sure. What a great idea. The patient and I have all the time in the world. Let’s do this all over again.

Until we are seen and heard.

[Department of Medicine at UCLA Health @DOM_UCLA]

Match Day is here! Our internal medicine residents are celebrating their fellowship match results with "matcha day" donuts and plenty of joy. Tune in at 5PM to meet our incoming fellows and see where our residents are headed next! Congrats to all! #FellowMatch #Match2025

[Mina Ma @MinaMa_MD]

New PC interns have arrived! Mission driven and ready to take care of patients! ❤️ #primarycare @DOM_UCLA @uclaimchiefs @UCLA_GIMHSR

[Zaven Sargsyan @sargsyanz]

In turn, their number was based on a single study of 49 patients from 1984… that studied CT *cholangiography* - not your usual CT!

https://t.co/ZPmOEmDSGc

9/

[Nick Mark MD @nickmmark]

But what if we provide 'too much' supplemental oxygen?

This can cause the loss of hypoxic vasoconstriction increasing perfusion to the poorly ventilated alveoli.

(Maybe a better term would be HYPERoxic vasodilation! h/t @sargsyanz for suggesting this perfect term!)

13/

[Kimberly Blumenthal, MD, MSc @KimberlyBlumen1]

👏👏BIG NEWS IN PENICILLIN ALLERGY!🧵/ To recap, a penicillin allergy is associated with bad outcomes for the individual and society, from treatment failures, to healthcare associated infections, to antimicrobial resistance @ericashenoy @EricMacyMD /1 https://t.co/iyThwuVN0r

[Justin Rosati, MD @JustinRosatiMD]

This is irresponsible and going to cause serious harm to children.

This is what can happen to a baby’s brain without vitamin k at birth.

He has no qualifications to make these recommendations and has never had to sit with families and deliver awful news.

[Adi @IDdocAdi]

Happy ID pharmacist day #stewardmeme

[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

[Houssein Safa, MD @hsafaMD]

Unpopular opinion but if a trainee asks you a simple medical question that you can answer in 2 min during rounds plz don’t ask them to look it up themselves when you have the needed information at your immediate disposal. It’s both discouraging and inefficient. Agree? Disagree?

[Prathit Kulkarni, MD @PrathitKulkarni]

@tchen091 Sure! I used the phrase “might have UTI” because the presence of pyuria does not confirm the diagnosis.

Basically, if there is pyuria plus symptoms, it’s suggestive of UTI.

No pyuria means UTI is extremely unlikely.

Pyuria with no symptoms is also probably not UTI.

[Dr. Saskia Popescu @SaskiaPopescu]

This is deeply worrisome - locally acquired dengue in AZ. Maricopa County health officials report 1 case of dengue, offer free at-home tests https://t.co/otqCcld1iS via @azcentral

[Eduardo R Argaiz @ArgaizR]

Young pt ➡️ 🏥 worsening shortness of breath

PMH: ESRD. Only 1 HD session/week. However, residual urine volume has now decreased substantially

On exam: BP 134/94, 2L O2,🧠✅, elevated JVP, decreased 🫁 sounds at bases, No murmurs, very mild edema. Functional left BC AVF

1/13

[Graham Walker, MD @grahamwalker]

Please settle a disagreement with ENT (for ER/Urgent Care, Primary Care, ENT):
Healthy 24M presents with R sided sore throat x3d. Tiny bit of uvular deviation toward the left.
No fever. Little trismus. Tolerating secretions but with pain.

Poll below, vote on management:

[Abraar Karan @AbraarKaran]

“Risk for cardiac complications was significantly higher after #SARSCoV2 infection than after mRNA COVID-19 vaccination for both males and females in all age groups.”

https://t.co/IPAwdU91oN

[Tony Breu @tony_breu]

1/16
Why do we use 100,000 CFU/mL as our cut-off for true bacteriuria?

This question was posed to me by @BryanCiccarelli. The answer has an interesting history so I thought I'd share it here.

[Ed Yong is not here @edyong209]

Fourth, America is accepting not only a threshold of death but also a *gradient* of death. Older, sicker, poorer, Blacker or browner—the people disproportionately killed by COVID are being treated as marginally in death as they were in life. 9/ https://t.co/CZr7fKThHK

[Paul Adamson MD MPH @PAdamsonMD]

#Poverty remains a major risk factor for #COVID19 infection, hosp, and death (& not only in LA)

*This is not normal*

As we move into a post-surge phase, we must demand #healthequity to protect our most #vulnerable groups. Community wealth shouldn't determine community health.

[Michael Raddatz @MichaelR21]

@SatyaPatelMD @MichaelAyoubMD Xuchen and I were channeling our best Troy & Abel In The Morning energy for the first half of that case conference. We can call @howdoyouflu the special guest… Great teaching case, @hunter_launer!