1/ Med stud: “AST is elevated so I’d like to get an ultrasound” Hm okay — what are you looking for? “Liver disease… Idk, his AST is ⬆️” *reaffirm* You’re absolutely right in associating ⬆️ AST with liver dysfunction However — is it ONLY associated w liver dysfunction? “…”

@CoryRohlfsen @ASanchez_PS @StefanKertesz @YihanYangMD @KirtanPatolia @EndoDialogues Not a “natural cure” but a similar “beware of false reassurance”: Normal sats (or minimal O2 req) in a pt with profound respiratory distress — non-alveolar dyspnea. I’ve seen “ADHF” ➡️ compensatory tachypnea iso DKA, & “COVID PNA” ➡️ massive PTE that unfortunately PEA’d in ER

@CoryRohlfsen We should collect cases like these and standardize a Cognitive M&M curriculum of sorts! I’ve been doing something similar but running out of cases😂 @ASanchez_PS is your mission w @Dx_Atypia similar or completely unrelated?

@ASanchez_PS @CoryRohlfsen @StefanKertesz @YihanYangMD @KirtanPatolia @EndoDialogues @Dx_Atypia @MadellenaC Was gonna say severe transient abdominal pain f/b BRBPR, both of which have since “resolved” spontaneously — ischemic colitis

@CoryRohlfsen @rabihmgeha @CPSolvers @medrants @DrDanRestrepo @AdamRodmanMD @adamcifu Amazing distinction, love that. We emphasize NPV of pertinent ➖s and PPV of pertinent ➕s — but never the NPV of the ABSENCE of a pertinent ➕ ie absence of hyponatremia isn’t sensitive enough to rule out AI Look forward to reading that^!

@medrants @PrathitKulkarni You’re absolutely right. Meant adrenal insufficiency, short handed for the sake of character counts

@CoryRohlfsen @TheOpEdProject @micheleweldon Thank you @CoryRohlfsen, means a lot Love that — sounds like a wealth of wisdom is shared in those talks! Agreed. Certainly a bit utopian (by secular standards, otherwise just heavily spiritual/faith-based) but hey, we each serve our small purpose as a beacon of light

@katieorenst @TheOpEdProject @micheleweldon Thank you! Owe much of it to @micheleweldon’s mentorship through the process!

RT @cliffreid: Here’s how I think we often fail our patients when treating ’sepsis’ a 🧵 1/11

Thankful to have snuck my way into this group of outstanding individuals and even more outstanding community — @MGHHMU modeling what academic Hospital Medicine is meant to be

@TheOpEdProject Curious if this resonates with you @DxRxEdu, considering your pride in your heritage as well. Or welcome a conflicting perspective!

@CoryRohlfsen @DrCasteelEM ER nurses halfway into my month in the ER as a resident: “Ahhh so you’re the guy who keeps ordering a phos down here” 😂

@CoryRohlfsen @CoryRohlfsen praying for you, your family, and your community

4 years ago, my uncle passed. Yesterday, I finally made it to his annual commemoration liturgy & family reunion. Went to his grave and said my proper goodbyes. Brought peace and joy to an aching heart. #IncomingInterns, don’t make my mistake — nothing is more important

RT @katiewiskar: Me: orders vancomycin for patient Phone rings - Pharmacy: “Do you really want X dose for this patient?” Me: “Absolutel…