Student of the world, dream catcher, truth seeker, internist. Optimistic with a hint of skepticism, thankful for little things in life. Exists to learn & serve.
Bangor, ME
Joined May 2009
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- Following195
- Followers189
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Joan retweeted
When I make videos about the US healthcare system, I try to do it in a way that is accessible to everybody. If you do advocacy work, please feel free to use these videos in presentations or send them to your Congress person. Keep advocating. youtube.com/playlist?list=PL…
Joan retweeted
Following Elsevier's decision to raise the APC for NeuroImage to $3,450, all editors (inc. EiCs @fmrib_steve @tobergmann @BirteUta) from NeuroImage and NeuroImage:Reports have resigned, effective immediately. I am joining this action and have also resigned imaging-neuroscience.org/Ann…
ALT Resignation statement. See https://imaging-neuroscience.org/Announcement.pdf for full announcement.
Joan retweeted
1/ #UncleBob has been thinking about the road to Diagnostic Excellence. Sometimes we spend all our energy teaching Diagnostic Errors, but the road to excellence is not necessarily the opposite of avoiding errors. @CPSolvers @DxRxEdu @rabihmgeha @andrewolsonmd @uabimres
Joan retweeted
Here’s a video I made breaking down an important Echo recorded during cardiac arrest
#FOAMed
Joan retweeted
1/🧵
Ever wonder why rheumatic heart disease almost always damages heart valves?
And why is the mitral valve by far the most commonly affected?
The answer involves a case of mistaken identity.
#medtwitter #tweetorial
Joan retweeted
1/11
A 55 y/o man presents for evaluation of chronic diarrhea. We walk into the room to meet him.
We have an opportunity to make an “augenblick” diagnosis – one that can be made in the blink of an eye.
Joan retweeted
Time for part 4️⃣ of my comparative physiology series:
Case 1
You are called about an elevated blood alcohol level in an inpatient.
"That’s impossible," the tech says, "he’s been admitted to the ICU for a month!"
It’s totally normal, you say, because the sample came from a __
1/
47%🐠 Anoxic goldfish
20%🦇 Aestivating bat
19%🐘 Staggering elephant
14%🐁 Pen-tailed shrew
778 votes • Final results
Joan retweeted
ID when they see Vanc/zosyn ordered for “bilateral cellulitis” #stewardmeme teapawt.net/Skeeter696969/status/1…
Joan retweeted
#HFpEF pearl of the day: Once the Dx of HFpEF is made, the 1st step is looking for and Rx'ing congestion, then Rx'ing comorbidities, and then exercise/weight loss program. I use sequential nephron blockade to minimize loop diuretic dose, always try to use MRAs when possible.
Joan retweeted
Poor quality sleep is linked to the deposition of #βAmyloid in the brain over time. jwat.ch/2SwW4Zk #AlzheimerDisease
Joan retweeted
Since its inception in 1812, this is only the 4th time an editorial has been collectively signed by the entire NEJM Editorial Board.
That should tell you something about how the medical community views the nations current leadership around #COVID
nejm.org/doi/full/10.1056/NE…
Joan retweeted
1/15 #MedTwitter: You're admitting a 64YO male with ESRD on HD for hyperkalemia after missing dialysis. A troponin was checked & returned at 0.78 (nl<0.055 ng/mL), similar to his baseline. He is w/osymptoms and EKG is w/o dynamic changes. What would you call this #tropbump?
13%Type II MI
18%Myocardial Injury
8%MINOCA
61%Troponinemia!!!
2,821 votes • Final results Joan retweeted
Bit by bit, the FDA & CDC's strengths have been pecked away to insure fealty to the President instead of the people. The damage will take years to undo. For those who devoted our lives to serving the health of those people, I cannot express how difficult seeing this is.
I can't remember a single incident in my nearly eight years running the CDC or 20 years working there when any entity forced the agency to change its guidance. We can't let politics get in the way of science. to.pbs.org/34GB9ug
Joan retweeted
1/ #Morningreport @SinaiBmoreIMRes
featured a 65 yr old M with syncope He was walking to kitchen when he fell, no prodromal symptoms, denies bowel, bladder incontinence.
He reported unintentional weight loss since the last 2 months.
#DDX ?
#MedTwitter #MedStudentTwitter #meded
Joan retweeted
“Hold to the inner vision of gradual flowering of potential. Avoid haste. Do not jump ahead blindly. Enjoy the moment of waiting to be!” - Lao Tzu, Tao Te Ching
Joan retweeted
Low anion gap (AG) causes:
1⃣Decreased "unmeasured" anions
➡️low albumin (#1 cause of low AG)
➡️hypophos
2⃣Increased chloride
➡️hypertriglyceridemia
➡️bromide/iodide
3⃣Extra "unmeasured" cations
➡️paraproteins (multiple myeloma)
➡️hyperCa/hyperMg/hyperK
➡️lithium
➡️polymyxin B
