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Here’s a video I made breaking down this case of a 50-year-old man who suddenly went into cardiac arrest while in bed with his wife #FOAMed

Hypercalcemia of malignancy Complicates ~30% of cancers & portrays a ⬇️ prognosis 4 mechanisms: ⭐️PTHrP (80%): 🫁, SCC, 🫘, ovarian ⭐️Lytic 🦴dz (20%): solid>liquid (🥇breast), myeloma ⭐️1,25-Vit D: Hodgkins>NHL ⭐️PTH (rare) Tx: IVF, bisphosphanates, calcitonin, denosumab

Each RBC has to pass the quality control of the spleen by passing from the splenic cords to the venous sinuses about 12,000 times in its lifetime (PMID 36753606), only on its final journey to be snatched and eaten by a macrophage in the cords. Not an easy life to be an RBC!

The beautiful color spectrum of bruises!

Confession: I LOVE hyponatremia 🤓 (I know, I know. What can I say, I'm a true internist!) HypoNa is often feared, maligned, and misunderstood - but I promise it doesn't have to be scary! Here are my top 10 hyponatremia tips and tricks - a 🧵

One of the most important trials at American College of Cardiology #ACC25 ! Compared fluid restriction to liberal approach in #HeartFailure. Why? This affects individuals w/HF EVERY DAY! ✨No benefit of Fluid Restriction ✨No HARM for liberal fluid intake ✨Improved QOL in liberal fluid intake

Can a patient be fluid responsive and venously congested at the same time? Yes — and this changes everything. Our recent study shows how bedside ultrasound can reveal what clinical signs often miss. Let’s break it down: #POCUS #VExUS #CriticalCare 🧵

Congratulations to @PCSDsutherland senior Aaliyah Nicholas for earning a spot in the top 10 of the NYC Bound regional Jimmy Awards Competition for performing arts! #PittsfordPride #IamPittsfordSchools

Quick ECG Clues Every Clinician Should Know😍

1/ You might think: "Why give NaCl to someone overloaded with salt and water? Shouldn’t we be pulling sodium out, not putting it in?" 🧂💧 It feels wrong — but correcting chloride can unlock natriuresis. Let’s break the paradox. 🧵

Frederik H. Verbrugge Eduardo R Argaiz Some pearls of wisdom on this subject in this thread 👇🏻

🚨 Heart failure (HF) decongestion ≠ simple fluid removal. Let’s explore the fascinating electrolyte changes happening behind the scenes and how they interact with diuretic therapy. 🫀💧⚡ Here follows a thread.🧵 Full review by Frederik H. Verbrugge and me: onlinelibrary.wiley.com/doi/10.1002/ej…

🧵1/ Hypovolaemia is the most overdiagnosed concept in medicine. We say it reflexively — especially in sepsis. But here’s the uncomfortable truth: We can’t measure blood volume. We infer it. Often wrongly. Let’s unpack why that matters. 👇 #MedTwitter #FOAMed

1/ Most people think the heart drives circulation. But what if that’s backwards? Anderson’s model flips the whole idea of cardiac output on its head — and it changes how you think about fluid, flow, and failure. 🧵👇 #physiology #FOAMed #MedTwitter #criticalCare #cardiacOutput

💥 July 1 is coming. That means brand new interns and brand new Neuro residents! Ready to turn that reflex hammer into a GPS for finding lesions? Let's review how to localize using your neuro exam 👇

🧵 Lymphangions: The Hidden Pump Protecting You From Oedema 1️⃣ What if I told you that you have hundreds of tiny hearts quietly pumping litres of fluid every day? They’re called lymphangions—segments of your lymphatic system that actively contract to return interstitial fluid to

Rajiv Ashley Miller Philippe Rola Eduardo R Argaiz NephroPOCUS 3/3 followed by a clinician brainstem reflex to continue a prescription of more fluids that temporarily improve MAP at the expense of further uncoupling of the circulation and worsening tissue perfusion. Rinse, repeat. Patient dies despite “we did everything we could”.

Right here. And that clinician is truly misled by the fact that there was a brief positive response to the fluids. “They really needed it, they just need a bit more and everything will be ok.” Its well-meaning but cam be fatal.

Critical famine risk in Gaza. Support IRC - International Rescue Committee. The International Rescue Committee helps people whose lives and livelihoods are shattered by conflict and disaster to survive, recover and regain control of their future. help.rescue.org/donate/evergre…

Choosing the right anticoagulant The Curbsiders #MedX