Nicolás López

Trabajo como especialista en Medicina de Emergencias. Posteo casos e imágenes médicas de Dx desafiantes. Se solicita consentimiento a pacientes.

[Leonardo Soto Muñoz @LeonardoSotoMu]

Cómo prepara 500 mL solución salina hípertonica al 7.5% usando Nacl 23,4% y NaCl 0.9%?
Preguntica?

[Ricardo Castro @RCastro_L]

Our last writing. "What every intensivist should know about the biphasic kinetics of lactate in septic shock" https://t.co/9elOVWj48D

[Practicon @moy_qmac]

Veamos otro de esos casos que no deberia haber visto como reumatólogo pero CREO llegué al diagnóstico.

No puedo asegurarlo porque no pude presenciar la mejoría pero fue un caso raro.

[Doc Navarrow @DocNavarrow]

🍩🍩If you spot a double doughnut sign on MRI, what comes to your mind (besides your calorie count)?

🧠🤔

[Eddy J. Gutierrez, MD @eddyjoemd]

Pts who present w/ "toxic metabolic encephalopathy" present unique challenges going down the diagnostic rabbit hole. As much as there is a societal aversion to LPs, getting it done early is helpful before empirically treating them. 🎩 tip to the authors.
https://t.co/Sfr6vCn6le

[NephroPOCUS @NephroP]

Great visual showing how LVOT VTI increases with inotropic support!
#POCUS #FOAMed #Nephpearls

[Eddy J. Gutierrez, MD @eddyjoemd]

Nasal high flow oxygen is a tool I use daily in the ICU. The ROX index can also be helpful in certain situations. Here's how those two work. 🎩 tip to the authors.
https://t.co/Sfr6vCn6le

[Eddy J. Gutierrez, MD @eddyjoemd]

Anemia on admission tells us a lot about the patient's baseline, but it makes a dramatic difference in outcomes in cardiogenic shock. Hb < 11 = 64% increase in 1-month mortality. 🎩 tip to the authors.
https://t.co/Sfr6vCn6le

[Braydon Dymm, MD @BraydonDymm]

It's official. For acute stroke treatment, Alteplase (tPA) is out, and Tenecteplase (TNK) is in.

But why? And more importantly, why is it called TNK when there’s no “K” in Tenecteplase?? 🧵

[ANDROMEDA-SHOCK @AndromedaShock]

The physiological background of ANDROMEDA-SHOCk-2 and ANDROMEDA-PEGASUS!!!! A2 analysis is almost there but we are pretty optimistic! Opening avenues for personalizing initial hemodynamic management! Cross-fingers

[Eddy J. Gutierrez, MD @eddyjoemd]

When a patient presents with mottling among their constellation of signs, symptoms, and labs, there is a look that team members give each other that we've all seen. It's not a positive look. Here is some data reinforcing our intuition. 🎩 tip to the authors.
https://t.co/8F34NNEcAj

[NephroPOCUS @NephroP]

Funny paradox is that even for managing #hyponatremia or #dialysis patients properly, you need #POCUS. Yet some senior nephrologists, particularly some journal editors, seem determined to dismiss it, just because they don’t understand its value. Academic medicine is supposed to be about lifelong learning, but some folks treat new tools as threats to their authority. It’s disappointing.

[Eddy J. Gutierrez, MD @eddyjoemd]

Do you need to emergently reverse the DOAC your patient recently taken due to a major bleed? Here are some strategies to do so and potentially save your patient from further harm. 🎩 tip to the authors.
https://t.co/Sfr6vCn6le

[Eddy J. Gutierrez, MD @eddyjoemd]

Guillain-Barré syndrome can present in various ways and atypical forms. This paper can help intensivists in diagnosis and management (including ventilator management). The differential diagnosis is very broad. 🎩 tip to the authors.
https://t.co/Sfr6vCn6le

[Ken Milne MD @TheSGEM]

I want my positions to map as close to reality as possible (ie the truth).

Not personally identifying or being emotionally attached to a position helps me assess & change when provided with sufficient evidence.

Minimizing biases can come across as being cold at times.

[NephroPOCUS @NephroP]

Old point, new style!
#POCUS #Nephpearls #MedEd

[NephroPOCUS @NephroP]

#VExUS score Is Associated with Worsening Renal Function and Reduced Natriuretic Response in Patients with Acute #HeartFailure
#POCUS #FOAMed #Nephpearls
🔗 J. Clin. Med. 2024, 13(20), 6272; doi: 10.3390/jcm13206272

[Dr sthanu subramanian @drsthanus]

Approach to Cognitive Decline.

A flowchart outlining the diagnostic approach to cognitive decline, a common symptom in neurodegenerative disorders.

It differentiates between rapid and chronic cognitive decline and suggests investigations and possible diagnoses

[ANDROMEDA-SHOCK @AndromedaShock]

ANDROMEDA-SHOCK-2 Recruitment finished!!! 1500 pts in years!!!💪💪💪😍😍😍🍷Now let’s go for ANDROMEDA-PEGASUS!!!!💪💪💪💪