Jonathan Hillyard, DO

Current general cardiology fellow. Prior Virginia Commonwealth University Chief Medical Resident. Tweets are my own opinion.

[Jonathan Hillyard, DO @JCHillyard]

#MRpearls ⬆️troponin following seizures may suggest underlying CAD. Check out this article!🚫elevation was found in pts with a healthy CV system. https://t.co/tKhjVsJCyy
@VCU_IMRes @JCook2035 @AjayPMD @jaideeppatelmd @KrisReports @pranav_mankad @b_law16 @alex_pandelidis

[Jonathan Hillyard, DO @JCHillyard]

@ktwaybill @ptfaddenMD @VCU_IMRes @ZoeXZhang @Rujuguju1 @nehahipp @RaslanRasha @AudreyBJernigan @chrisLyoungmd @DrJaredDyer @scall1200 @rvawellmd @ptfaddenMD facilitating like a champ! Always learn so much from his thought process and clinical reasoning!

[Jonathan Hillyard, DO @JCHillyard]

#MRpearls remember the BR level is at least 2-3 when you see scleral icterus! Supports how much you can predict from a good physical exam! @DrJaredDyer @AudreyBJernigan @ktwaybill @chrisLyoungmd @VCU_IMRes @scall1200 @cderekleiner @RaslanRasha @ptfaddenMD

[Jared Dyer, DO @DrJaredDyer]

#MRPearls Another approach to anion gap metabolic acidosis is the GOLDMARK mnemonic which has replaced the outdated MUDPILES mnemonic. @marinanaz @LauraLee714 @KidneyWars @NirajRKothari @B_M_Wiese @COvertonMD @nehahipp @AnchaliaC @palettala @michellebr00ks @bqueenhoo @rvawellmd

[Jared Dyer, DO @DrJaredDyer]

#MRPearls It is important to have a systematic approach to an anion gap metabolic acidosis in order to not miss anything on your differential. Check out this schema by the @CPSolvers. @VCU_IMRes @AudreyBJernigan @JCHillyard @chrisLyoungmd @ktwaybill @jkidd03 @VCU_Nephrology

[Jared Dyer, DO @DrJaredDyer]

#MRPearls In patients with a LVEF <35%, a wide QRS complex (>120ms), and persistent HF symptoms (NYHA 3,4) cardiac resynchronous therapy has been shown to improve outcomes. @VCU_IMRes @AudreyBJernigan @JCHillyard @AjayPMD @jaideeppatelmd

[Jared Dyer, DO @DrJaredDyer]

#MRPearls Do not forget to check the delta-delta ratio in the presence of a high anion gap metabolic acidosis to determine if there is a coexisting normal anion gap metabolic acidosis or metabolic alkalosis. @VCU_IMRes @AudreyBJernigan @JCHillyard @jkidd03

[Jonathan Hillyard, DO @JCHillyard]

#PayItForwardLIVE ready to listen to some Dave Matthews! Much needed! Thanks, Dave!

[Jonathan Hillyard, DO @JCHillyard]

Happy birthday!! @VCU_IMRes

[Jonathan Hillyard, DO @JCHillyard]

@AudreyBJernigan so fortunate to have you in my life! You are an amazing doctor, all-star "twitter-er", and most of all a wonderful friend. #C3POandiR2forever

[Becky Miller, MD @rva_IntMedPD]

Happy Match Day! Congratulations and welcome to our new Intern class! Congratulations to all medical students celebrating today. @VCU_IMRes @VCUInternalMed

[Jonathan Hillyard, DO @JCHillyard]

#MRpearls remember that ~30% of pts have a diagnosis of HTN and of those, ~15% have a secondary cause. One of the most common causes is hyperaldo. @VCU_IMRes @DrJaredDyer @AudreyBJernigan @chrisLyoungmd @ktwaybill

[Jared Dyer, DO @DrJaredDyer]

17/ #MRPearls Supervised exercise that includes walking at least 3x per week (30-60 min/session) for at least 12 weeks should be first line therapy for claudication. The CLEVER study in @circaha showed supervised exercise resulted in greater mean peak walking time vs. medical tx.

[Jared Dyer, DO @DrJaredDyer]

#MRPearls Can consider fecal immunochemical test (FIT) for blood for colorectal cancer (CRC) screening. It directly measures hemoglobin in the stool and should be repeated annually. The sensitivity for CRC is 73.8% and 23.8% for adenomas >10mm. @VCU_IMRes @AudreyBJernigan (1/4)

[Jonathan Hillyard, DO @JCHillyard]

#MRpearls remember this fantastic schema for hyperCa workup from the @CPSolvers. Remember to break it down between PTH dependent and PTH independent! @VCU_IMRes @lizzyvarnell @ptfaddenMD @Sullydoc101

[Jonathan Hillyard, DO @JCHillyard]

#MRpearls do you remember how loop diuretics work? Great review of physiology and pharmacology this AM. Remember that most diuretics are bound to albumin so they may not work in low protein states. @cderekleiner @VCU_Nephrology @VCU_IMRes @ktwaybill @AudreyBJernigan

[Jonathan Hillyard, DO @JCHillyard]

#MRpearls thank you @abouzaki_md for educating us on stable angina. Remember intervention is not always the answer. Medical therapy first with goal of two anti-anginal agents before thinking LHC. Consider even in patients with an abnormal stress test. @VCU_IMRes @ktwaybill

[Katie Waybill, MD @ktwaybill]

#MRPearls no transition point on abdominal CT scan is 94-100% specific for ruling out bowel obstruction! Always fun to see how @ptfaddenMD works through a differential with our @VCU_IMRes residents! @cderekleiner @JCHillyard @DrJaredDyer @AudreyBJernigan @chrisLyoungmd

[Jonathan Hillyard, DO @JCHillyard]

@ptfaddenMD @cderekleiner @ktwaybill @AudreyBJernigan @DrJaredDyer @chrisLyoungmd @VCU_IMRes Check out this great differential by @NEJM reviewing the differential of abdominal distention and shock.

[Jonathan Hillyard, DO @JCHillyard]

#MRpearls when evaluating dilated bowel and abdominal distention, measure the cecum diameter on CT. If >12cm, high risk for perforation. Lower risk if <9cm. @ptfaddenMD @cderekleiner @ktwaybill @AudreyBJernigan @DrJaredDyer @chrisLyoungmd @VCU_IMRes