Unremarkable Labs

Discussing unremarkable labs to improve clinical reasoning! •Started by @UABIMRes CMRs & @medrants. Come learn with us at your convenience.

[Paul Wischmeyer MD @Paul_Wischmeyer]

🫁 Chest X ray reading made easy
#MedEd #MedTwitter #FOAMed

[Robert Centor MD MACP 🇮🇱 @medrants]

#UncleBob proudly presents Annals On Call - Exercise for Knee Osteoarthritis: Is More Better? @AnnalsofIM https://t.co/efhcAr7a1M featuring @ppattyperez Physical Therapist

[Robert Centor MD MACP 🇮🇱 @medrants]

#UncleBob - if you are a hypercalcemia fanatic, you will likely love this
@rabihmgeha @DxRxEdu @CPSolvers @UnremarkableLab

The Case | A 48-year-old man with recurrent hypercalcemia and uremia after parathyroidectomy https://t.co/Qs9IUwl8UM

[Robert Centor MD MACP 🇮🇱 @medrants]

#UncleBob Hot take - the biggest problem in evidence based medicine is understanding that the lack of evidence FOR something does not provide evidence AGAINST something. It depends on sample size and type of available studies.

[Unremarkable Labs @UnremarkableLab]

Watch our first episode of the new year! Dr. Centor works through a case with a young woman presenting with abdominal pain.

[Robert Centor MD MACP 🇮🇱 @medrants]

#UncleBob and @NatashaMehraMD proudly present a new:

Unremarkable Labs: An Uncommon Presentation of a Common Pathology https://t.co/JzKvABx5tx via @YouTube
@uabimres
@DxRxEdu @rabihmgeha

[Robert Centor MD MACP 🇮🇱 @medrants]

#UncleBob and @NatashaMehraMD proudly present a new:

Unremarkable Labs: An Uncommon Presentation of a Common Pathology https://t.co/JzKvABx5tx via @YouTube
@uabimres
@DxRxEdu @rabihmgeha

[Journal of Brown Hospital Medicine @BrownJHM]

Tumor lysis syndrome @InternAtWork #MedEd

[USMLEmnemonic @UEmnemonic]

Cause of eosinophilia:PACCMAN
Parasites
Asthma
Churg-Strauss
Chronic adrenal insufficiency
Myeloproliferative disorders
Allergy
Neoplasia

[Rabih Geha @rabihmgeha]

#Medtwitter & #RheumTwitter

What conditions typically treated by rheumatologists prompt the possibility of an underlying cancer?

Dermatomyositis is one.

What are some others?

<3 @DxRxEdu

[2things @2thingsteam]

#2things Saturday
Patient with creatinine 3.5, BUN 120
1. Step 1 - look @ the urinalysis - pH 5, sp gr 1.010, >25 RBC, >30 WBC, 3+ protein

[Unremarkable Labs @UnremarkableLab]

A patient presents with hypertension, NAGMA, and elevated BUN/creatinine. Watch Dr. Eric Judd, UAB Nephrology Fellowship Director, and Dr. Centor @medrants, Professor Emeritus at UAB, work through this case and talk through multiple differential diagnoses. https://t.co/5yDMHiD9NS

[Joel M. Topf, MD FACP @kidney_boy]

Consult for hypercalcemia.

Patient had gone to their primary for a routine visit. Labs showed a calcium of 14.9 (Day zero). The next day the primary saw the labs and told them to go to the ED for AKI and hypercalcemia. First two sets of labs are below...

[2things @2thingsteam]

#2thingsSunday
1) A major dx to rule out in most acutely ill hospitalized patients is ADRENAL INSUFFICIENCY.
➡️ Hyperkalemia
➡️ Metabolic acidosis (NAGMA)
➡️ Hypoglycemia
➡️ Hyponatremia

- Check 4-6 AM cortisol
- Random cortisol must be ⬆️. “Normal”is not OK.
1/2

[2things @2thingsteam]

#2things Saturday

1. Diagnosing hyponatremia with dilute urine - pt had urine sp gr 1.004 (rule of thumb - multiply last 2 digits by 30) - said he drank as much beer as he wanted - non-specific - admitted that he ate little - therefore beer potomania - easily corrected w/ solute

[Robert Centor MD MACP 🇮🇱 @medrants]

Once again we diagnosed beer potomania. At a Na of 128 he had a major gait disturbance. Intern was amazed the this phenomenon really exists. We see it every few years. @uabimres @UnremarkableLab

[Robert Centor MD MACP 🇮🇱 @medrants]

#UncleBob loves this:
Serum Cystatin C for Estimation of GFR https://t.co/j6iFyX2CYx via @JAMA_current part of @JAMANetwork

@UnremarkableLab @2thingsteam @UAB_NRTC @uabimres

We have seen a couple of similar stories this year

[Unremarkable Labs @UnremarkableLab]

This week’s episode presents with a very abnormal BMP and a very interesting diagnosis. Join @medrants discuss a case with PGY-3 Julie England and @NatashaMehraMD. https://t.co/C3QAVRK2YS

[Şeyma @seymss15]

How does Cushing cause hypokalemia?

- One of the many questions that came up during today's @CPSolvers VMR weekly recap.😁

@rabihmgeha @MadellenaC @Rafameed @rav7ks @deboracloureiro 💙

For the answer, follow this thread :)

[Dr. Lisa Iannattone @lisa_iannattone]

Got consulted on a great case today. Thought I’d share since it’s a very distinctive rash that I’ve seen many times in books but never in real life before! This isn’t my patient but his eruption looked exactly like this. Any ideas? 😏

[Robert Centor MD MACP 🇮🇱 @medrants]

Interesting question last night, recording @UnremarkableLab - why is potassium repletion so important in a patient with chloride responsive metabolic alkalosis. Difficult to find a clear answer
@askrenal @kidney_boy @luck_urine @hswapnil