Marrow
@marrow_med
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Advancing the practice of medicine through evidence-based learning.
Bengaluru, India
Joined June 2014
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(1/4) The Modified Dukes Criteria for Infective Endocarditis has gotten its first major revision since 2000. This update incorporates microbiological techniques, surgical inspection, enhanced imaging techniques & more.
#MedTwitter
#MedEd
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During an emergency procedure, you chose the following site for a specific intervention. What is the advantage of this site?
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After 8 incredible years of leadership, we bid farewell to our founder
@DeepuSebin
as he officially resigns from his role at Marrow and DailyRounds. We are immensely grateful for his contributions to our team and the healthcare industry as a whole. As Dr. Deepu moves on to build
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A 3-day-old infant is brought with a rash. O/E, chorioretinitis, hepatosplenomegaly & hemorrhagic purpuric eruptions are noted, with no cardiovascular abnormality. CT head shows the following image. What is the most likely diagnosis?
#MedTwitter
#MedEd
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Intra-operative finding of a patient with vomiting and severe abdominal pain is shown. What is the diagnosis?
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Which would you be more likely to test for in the given condition: platelet function or microorganisms?
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A 48-yr-old woman with pain & stiffness in her hands & wrists, worse in morning for past few years. Presents with c/o irritation & photophobia in her left eye. O/E, swelling in wrists, MCP & PIP joints,ocular finding👇🏼 Name this finding & associated condition?
#MedTwitter
#MedEd
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Thanks, everyone for the warm welcome. Yes, I used to be
@RoundsMarrow
, now just Marrow.
PS: Admin is a fresh social media intern (ex-medical intern with expertise in intravenous cannulation and prolonged retractor maintenance)
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Update: We will further extend the validity of all Plan B & C students whose plans expire between June 1 & Aug 11 by tonight. For the other eligible exam-going students, we will make Short-term plans available from tonight.
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A child is brought by his mother to the ER with respiratory distress and biphasic stridor. The radiograph is shown. What is the diagnosis, causative agent and management for this condition?
#MedTwitter
#MedEd
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A 44-year-old previously healthy lady, presented with c/o pain in both her ankles, knees & elbows. O/E, a tender rash as shown. The CXR showed b/l hilar lymphadenopathy. Sr ACE level is increased, & rheumatoid factor is negative. What is the possible diagnosis?
#MedTwitter
#MedEd
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A 5-year-old girl with repeated falls while walking x 1 year, has difficulty in eating, gripping, or holding things. O/E, hand-mouth incoordination, slurring of speech & eye finding👇🏽noted. What is likely diagnosis & inheritance pattern seen in this condition?
#Medtwitter
#MedEd
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As an Intern, you observe a patient with the following suture. What could be the most likely condition that was treated?
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Examination of the limb of an agricultural worker with complaints of swelling and discharge is shown. What is the most likely diagnosis?
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A patient with CML presents with the following observation. What is the most likely underlying cause?
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A patient with infective endocarditis is started on an IV antibiotic, and he develops the reaction as shown 👇🏽within a few mins of starting it. Name the adverse reaction and the most likely antibiotic causing this reaction?
#Medtwitter
#MedEd
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A young boy presented with a bulge in the abdomen, which appears when straining. Is treatment necessary for this condition?
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What is the classical presentation of the condition with the following examination findings?
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1/2 A groundbreaking malaria vaccine 👇🏼
RTS,S/AS01, the 1st WHO-recommended anti-malarial vaccine for children b/w 5-17 months, in regions with moderate-high transmission of P. falciparum. Given 0.5 ml, IM in 3doses (0,1 & 2months) + booster dose (18 months after 1st dose)
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An old lady presented with C/O of retro-orbital pain, and diplopia. O/E a triad of 👇🏽 finding + orbital bruit + chemosis of the eye was noted. What is the likely diagnosis & Investigation of choice in this condition?
#MedEd
#MedTwitter
video source:
@grepmeded
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The MRI of a woman who recently had a childbirth is shown. What is the diagnosis?
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Findings from a young male complaining of headache and myalgia, following a trek. What is the most likely diagnosis?
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(1/2) ⌛️Update: India’s 1st indigenously prepared quadrivalent HPV vaccine
Cervavac (qHPV) vaccine aims to ensure robust immunity (90% protection) against papillomavirus.
🔹Type of vaccine: L1 capsid Virus-like particles of serotype 6,11,16,18
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The Nipah Virus has once again surfaced in the country, marking the 3rd occurrence in the past 5 years. Here is a
#PollThread
on NiV.
#NipahVirusAwareness
#MedTwitter
#MedEd
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Update: We have extended the validity for all Plan B & C students whose plans are expiring between June 1 & July 30. Know more:
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Q. 28-year-old man was evaluated for chronic abdominal pain, low-grade fever, diarrhoea, weight loss & fatigue. Colonoscopy, histopathological & barium study finding 👇🏽. What's the diagnosis?
#MedTwitter
#MedEd
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Save this🧵
1/6 Common
#druginteractions
to watch out for in your practice
#MedEd
💊MAO Inhibitors & SSRIs - Combining these antidepressants can land a patient in ICU with serotonin syndrome due to increased 5-HT levels. Ensure a washout period when switching between these two
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A 45-year-old man with end-stage renal disease presents with bone pain. O/E, he has tenderness over bony prominences & waddling gait. Lab reveals ⬆️ Sr calcium, phosphate & ALP + low Sr PTH. His X-ray LS spine 👇🏾. Name the finding & the most likely diagnosis?
#MedTwitter
#MedEd
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What is the advantage of using the following device post-operatively?
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A 17-year-old boy c/o pain & swelling of right knee x 1 week, progressed to ankle joints & feet. He says it all started after the episode of diarrhoea & burning micturition 2 weeks ago for which he was treated.👇🏾lesions were noted. What is the likely diagnosis?
#MedTwitter
#MedEd
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Ophthalmic findings of a young male complaining of severe eye pain and vision disturbances. What is the most likely cause?
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A 52-yr-old alcoholic male presented after fall with ⬇️ coordination,ataxic gait,dysarthria & tremors. He appeared malnourished,confused & had impaired memory. Symptoms persisted despite initiating treatment for alcohol withdrawal & detoxification. MRI 👇. What is the diagnosis?
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A young woman was instructed to breathe in and out of the bag as shown, which condition is most likely being treated by this technique?
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What advice would you give a middle-aged woman with the following findings?
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Examination of a full-term baby revealed the findings shown. What is the most likely diagnosis?
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⌛️Recent Update: From Jan 1, 2023,
@MoHFW_India
has introduced a 3rd fractional-dose Inactivated
#poliovaccine
(fIPV) in the Universal Immunization Programme to further enhance immunity against the disease. So far, only 2 doses of fIPV 0.1ml (at 6 & 14 wks) were administered.
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Updated FIGO staging 2023: A thread!🧵
(1/7) - After 2009, a major new update has come to the FIGO staging for endometrial cancer
#FIGO2023
#RevisedFIGO
#MedEd
#MedTwitter
#MedX
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What should you evaluate in a neonate if the examination finding shown, is absent?
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35-year-old woman k/c/o hypertension, presents with headache, burred vision & ⬇️urine output. O/E: BP- 160/100mmHg & abdominal bruits present. Renal angiogram finding👇🏽
What's the probable diagnosis?
#MedTwitter
#MedEd
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A 28-year-old woman with c/o double vision, frequent falls, & numbness in both hands. O/E, the radial pulses were not palpable, but the femoral pulses were palpable. An aortic arch angiogram was done the finding is shown👇🏽. What is the most likely diagnosis?
#MedTwitter
#MedEd
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Unable to gain IV access in a hypotensive patient, you resort to the following procedure. What are the possible sites for this intervention?
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A 50-year-old male complains of irregular discoloration of skin at the site shown, along with increased hair growth. What is the most likely diagnosis?
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Public Service announcement: GT progress graph can be viewed at the subject level as well.
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(1/5) An 11-year-old boy from Rosario, Argentina had c/o short stature, the US: LS ratio suggests proportionate short stature. He was 4.2 ft tall, with no dysmorphic features. Sounds familiar, doesn't it?
Yes! Lionel Messi was just 11 years old when he was diagnosed with GHD.
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(1/4) 🧵
India’s 1st ever- National Suicide Prevention Strategy 2022
#MedTwitter
#MedEd
#MoHFW_INDIA_Update
#SuicidePrevention
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Which of the following incisions is preferred during diagnostic laparotomy?
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Farmer with h/o walking barefoot presents with a painful, erythematous lesion as shown. Blood picture shows mild eosinophilia.
What is the probable diagnosis & treatment?
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The findings from a 36-year-old woman with cough, breathlessness, and abdominal fullness are shown, what is the most appropriate diagnosis?
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What are the necessary investigations to support a young boy's diagnosis with the examination findings shown?
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13-year boy with progressive muscular weakness, he uses his hands to walk up his body from squatting. His LL appears👇🏽. Lab->⬆️CK level, dystrophin mutation in genetic analysis. What's the diagnosis & tests that must be done periodically as part of surveillance
#MedTwitter
#MedEd
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A 7-year-old boy presented with the sign shown below for which enucleation was done. The histopathological finding is as shown👇🏽. Identify the marked finding & the associated likely diagnosis.
#MedTwitter
#MedEd
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#Update
: Chikungunya, marked by debilitating symptoms and a lack of specific treatment or effective prevention, has led to the FDA's approval of IXCHIQ—the first vaccine designed for individuals aged >18.
This live, lyophilized vaccine acts by deleting non-structural protein 3,
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X-ray of an elderly male with hemoptysis and cough is shown. What is the most likely diagnosis?
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Under which color would you triage a patient with the following radiological finding post-RTA with GCS 8?
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A 7-month-old child was brought by his mother with complaints of diarrhoea & mucocutaneous lesions as shown 👇🏽. The symptoms began when weaning was started. What is the diagnosis & how would you manage this condition?
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(1/6)
#VEXAS
syndrome: A Novel
#disorder
discovered in 2020. VEXAS is an adult-onset inflammatory disease with clinical features that bridge
#rheumatologic
&
#hematologic
conditions.
#MedEd
#MedTwitter
Image:
#njem
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Following complaints of weakness in the left arm, the test shown was performed yielding a positive result. What is the most likely cause?
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International Endocrinology associations recommended that the name Diabetes insipidus, in some cases has led to harm as its confused with Diabetes Mellitus
New proposed names:
Arginine vasopressin deficiency (AVP-D) 👉🏻Central. Arginine vasopressin resistance (AVP-R)👉🏻Nephrogenic
Read & share the statement calling for a name change for diabetes insipidus to help protect patients & reduce confusion about the condition.
@Pituitary_org
@ClinEndocr
@EndoConnect
@TheEndoSociety
@ESEndocrinology
@PituitarySoc
@EndoKarger
@EJEndo
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What is the characteristic speech observed in a patient who has difficulty performing the test shown?
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🧵(1/6) In just 1 week, the frequency of
#PinkEye
in Mumbai has 📈by 210%. According to state government data, there were 1275 cases in the first week of Aug, compared to 607 cases noted through July 31 this year. Let’s understand the types of
#conjunctivitis
#MedTwitter
#MedX
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What is the most common adverse effect of using this spinal needle?
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The hepatic copper levels of a patient with the finding shown, turned out to be normal. What are the other conditions you would consider as the cause?
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A patient presents with the following findings. Is the origin dermatological or psychological?
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What is the most likely cause of the findings on the MRI of a male with recurrent seizures and headaches?
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42-yr male c/o severe pain, photophobia & lacrimation in left eye. No h/o trauma. VA in left👁: 6/24. Slit-lamp👉🏾crescent shaped peripheral corneal ulcer with undermined edges. Fluorescein staining finding👇🏽What is the diagnosis?
#MedTwitter
#MedEd
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#Update
: FDA grants approval for the use of Zuranolone - the first ever oral medication in the treatment of Postpartum Depression (PPD).
Zuranolone enhances the activity of the GABA neurotransmitter, effectively regulating mood and anxiety in the brain. Administered once daily
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A 46-year-old woman was taken to the ER for sudden breathlessness that had worsened over the past few hours. Examination shows cyanosis with no rash. There is a history of surgery for a closed femur fracture two weeks ago.
What is the most probable diagnosis?
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What is the causative factor of the characteristic finding shown, in a child with high fever, and lymphadenopathy?
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Investigation of a 34-year-old male with recurrent purulent nasal discharge and facial pain revealed the following findings. What other investigatory test would you perform on this patient?
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With growing concerns about an increase in the cases of Zika virus infection in India, here is a
#pollthread
on
#Zikavirus
#MedEd
#MedX
#MedTwitter
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A 55 year old patient came with complaints of tremors, palpitations, and difficulty closing the eyelids. She was examined. What is the commonest and earliest sign of this disease?
#MedEd
#MedX
#MedTwitter
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A 18-year-old boy presented with the following finding; What is the most probable diagnosis and the inheritance pattern commonly seen in this condition?
#MedTwitter
#MedEd
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The following test showed a positive finding when performed on a young man who complained of right knee pain and difficulty walking. What is the most likely diagnosis?
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ECG of a 55-year-old male with chest pain and light-headedness. What is the most likely diagnosis?
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What would you suggest as lifestyle changes to prevent future attacks of the following condition?
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Introducing Marrow for First Years - a complete course for 1st-year MBBS students to build strong concepts & prepare for professional exams.
Dr. Ashwani Kumar, Dr. Rebecca James, and Dr. Krishna Kumar will be part of the course. They will provide 180+ hours of video classes with
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(2/4) The criteria divides IE into 3 distinct categories - Definitive, Possible & Rejected endocarditis. The condition can be classified as Definitive IE when the Pathological criteria along with 2 major OR 1 major & 3 minor OR 5 minor clinical criteria are met.
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A patient is brought to the OPD by his wife, who is concerned that he seems to be forgetting details. On further questioning, the patient reveals he is experiencing a feeling like he's going to fall while walking & difficulty controlling urination.O/E, vitals are stable. However,
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A 55-year-old patient with chronic kidney disease suddenly develops chest pain and palpitations. The ECG of the patient is shown below. What is the immediate management of this condition?
#MedX
#MedTwitter
#ECG
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⌛️Update: WHO's treatment guidelines for Drug-resistant TB
In 2022, a 32% increase in MDR/RR-TB cases in India was detected under NTEP. WHO in Dec '22 updated the initial treatment regime for MDR/RR-TB cases. This includes shorter 6-month BPaLM regime comprising Bedaquiline,
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The below finding was noted in a patient with blunt-force trauma to the chest. Name this characteristic finding, and how would you treat this patient?
#MedTwitter
#MedEd
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During a resuscitation procedure, you refrain from using the device shown on a particular patient. What could be the most possible rationale?
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A middle-aged male presents with lower limb paresthesia and vague abdominal pain. On examination, there is splenomegaly and a characteristic oral finding as shown. What would be the findings in the lipid profile of this patient?
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A 52-year-old male c/o rectal bleeding. He has h/o spontaneous & recurrent episodes of epistaxis for the past 10 years but has never been fully evaluated. His family history was also notable for a son with recurrent spontaneous epistaxis. O/E 👇🏽finding noted. Lab findings were
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How would you measure the size of the instrument used in this procedure?
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CT of a young woman presenting with sudden onset vertigo and headaches. Is this a case of malignancy or hemorrhage?
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2/2 RTS,S/AS01 is a pre-erythrocytic recombinant vaccine comprising a circumsporozoite protein of P.falciparum fused with HBV fragment. The vaccine stops the sporozoites from colonising the liver, preventing the parasite from entering the pre-erythrocytic stage of its life cycle.
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(1/5) A thread on Vamorolone, a novel corticosteroid, for the treatment of Duchenne muscular dystrophy (DMD)
#MedTwitter
#MedEd
#DMD
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⌛️Update: FDA on April 6 withdrew approval for Hydroxyprogesterone caproate (
#Makena
) after 12 years since its accelerated approval. The drug was used to prevent preterm birth in women with a h/o spontaneous preterm birth but failed to demonstrate effectiveness in post-marketing
Today, we announced the agency's decision to withdraw approval of Makena - a drug approved under the accelerated approval pathway to reduce the risk of preterm birth in women pregnant with one baby who have a history of spontaneous preterm birth.
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