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Tweet Pearls of the Week

Posted Sep 03 2012 12:00am

A good tweet is a terrible thing to waste. 

Here at Academic Life in Emergency Medicine, we will be collecting and posting important Twitter pearls in Emergency Medicine and Critical Care from the past week (August 24-31, 2012).

Come join in on the dynamic conversation.

[ View the story "Tweet Pearls of the Week 8/24 to 8/31" on Storify ]

Tweet Pearls of the Week 8/24 to 8/31

Storified by Javier Benítez · Sun, Sep 02 2012 18:09:54

Worth repeating: Default 1gm vancomycin dose usually not enough. Use 15-20mg/kg (actual body wt) X 1 and adjust for renal function later.Bryan D. Hayes
What is real time (dynamic) imaging?ED Ultrasound Q&A
Type of imaging in which the image is created so many times per second that a cinematic view of the tissues is obtained.ED Ultrasound Q&A
QOD: A child presents w/ a diffuse, maculopapular rash. He recently had a fever of 104 for about 4 days and just got better. Dx?Robert Cooney
aQOD: Roseola or Exanthem Subitum or Sixth's Disease, caused by HHV6; tx with antipyretics and timeRobert Cooney
QOD: What is the most common source(s) of orbital cellulitis? Bonus: common pathogens?Robert Cooney
aQOD: Causes: direct skin inoculation or direct extension from sinuses; pathogens: S. pneumo, H. flu, M. cat, anaerobes, StaphRobert Cooney
What's the most accurate outcome predictor w/ ICH a.Hematoma volume b. rate of growth c.initial exam d.time of onset to presentation (3) INREMedHome
And QoD Hematoma volumes are associated with higher morbidity and mortality; hematoma volume is the most accurate predictor of outcomeEMedHome
What are the signs of increased ICP on CT? Watch Dr. Josh Broder’s Video Pearls in Emergency Radiology: http://cloud.emedhome.com/features/5168.mp4EMedHome
Atropine (dl-hyoscyamine) is found in the Deadly Nightshade (Atropa belladonna) plant, and is a cornerstone in autonomic pharmacology. #AACTBryan D. Hayes
What is the knee?ED Ultrasound Q&A
Region of the curve where the slope changes markedly.ED Ultrasound Q&A
Q: What sign is seen in this gallbladder? What disease process does it suggest? #radiology #MedEd #ultrasound http://pic.twitter.com/DgBR5FVVRadiology Signs
A: Comet tail sign (ring down artifact) of adenomyomatosis http://goo.gl/d9PCT WINNERS @snotdok @BasemBahakeem @camnapper @elwoodiusRadiology Signs
Keep waiting 24 hrs after tPA to give aspirin in ischemic stroke. Early admin has more bleeding and no added benefit. http://www.ncbi.nlm.nih.gov/pubmed/22748820Bryan D. Hayes
What is the near gain control?ED Ultrasound Q&A
This knob regulates the amplification of echoes returning from the near field.ED Ultrasound Q&A
#UCSFtox ocular atropine can last for 3-4 days. Longer than predicted from published 2.5 hr half life.Derrick Lung
Q: Ultrasound in a two month old with vomiting. What sign is seen? Diagnosis? #radiology #ultrasound #MedEd #doctors http://pic.twitter.com/W6kCDUHORadiology Signs
A: Cervix sign (or Antral nipple sign) of Hypertrophic pyloric stenosis http://dlvr.it/23ghvv WINNERS @camnapper @dr_canales & nipple :)Radiology Signs
What are slide pots?ED Ultrasound Q&A
TGC controls can be adjusted in short segments with the use of slide pots. Use for fine tuning.ED Ultrasound Q&A
QOD: A pt presents w/ a swollen tender parotid gland. You suspect suppurative parotitis; What is your management?Robert Cooney
aQOD: hydration, sialogogues (gotta love lemon drops), and antibioticsRobert Cooney
Teaching pearl: "Feedback should deal with decisions and actions, rather than assumed intentions or interpretations." - Dr. Jack EndeBryan D. Hayes
What is the slope rate?ED Ultrasound Q&A
The rate at which echoes are suppressed or amplified as the depth varies.ED Ultrasound Q&A
QOD: A pt presents with refractory hypotension, lethargy, hyponatremia, hyperkalemia, & hypoglycemia. Dx & management?Robert Cooney
aQOD: Adrenal crisis; tx with 100mg of IV hydrocortisone and fluids; don't forget to look for an underlying causeRobert Cooney
Q: Post contrast T1 image. Name 3 features of this lesion that favor ependymoma over astrocytoma. #radiology #MedEd http://pic.twitter.com/NMZITtaPRadiology Signs
A: Well-circumscribed, centrally positioned, dense reasonably homogeneous enhancement http://goo.gl/lHPRv WINNER @camnapper Good job :)Radiology Signs
In hypothermic patients, insulin is ineffective below 30 degrees C.Bryan D. Hayes
Why is proper adjustment of the gain important?ED Ultrasound Q&A
It can vary the strength of the echoes throughout the image and make structures more clearly visibleED Ultrasound Q&A
QOD: In a patient with an inferior STEMI, what does ST elevation greater in III than II suggest?Robert Cooney
aQOD: If you see III elevated more than II in an inferior STEMI, think RCA occlusionRobert Cooney
Univ of Maryland conf pearl of the day: after failed resus's, review all documentation & make sure times of crit actions agree w/each otherAmal Mattu
UMEM pearl of day #2: approx half of malpractice cases turn on the basis of the quality of d/c instructsAmal Mattu
Obese ED patients are frequently underdosed when given antbiotics. And, this study didn't include vancomycin! Aim high. http://www.ncbi.nlm.nih.gov/pubmed/22169576Bryan D. Hayes
Q: Sagittal MRI of the knee. What sign is seen? Diagnosis? #radiology #orthopedics #MRI #MedEd http://pic.twitter.com/QrOGim1fRadiology Signs
A: Celery stalk sign of ACL mucoid degeneration http://dlvr.it/24P8kw Very common - NOT ACL TEAR!! No winner today :(Radiology Signs
Pts given charcoal in ambulance receive it >50 minutes sooner than pts who receive it in the ED. Recommend prehospital admin if appropriate.Bryan D. Hayes
QOD: A pt presents with fever, significant tachycardia, confusion, hypertension, and a CHF pattern on CXR. Suspected dx & tx?Robert Cooney
aQOD: Think thyroid storm in the given case, get labs & start tx with beta-blockers, PTU, & iodine; remember: look for an underlying causeRobert Cooney
Hydrogen cyanide was detected in blood samples from 169 of 285 fire-related deaths (59%) during enclosed-space fires. http://www.ncbi.nlm.nih.gov/pubmed/22882141Bryan D. Hayes
Q: What important sign is seen on this non contrast CT brain? Diagnosis? #radiology #MedEd #medstudent http://pic.twitter.com/bMI5pjcnRadiology Signs
A: Hyperdense MCA sign of hyperacute thrombus http://goo.gl/HYRWM WINNERS @camnapper @AndyNeill @AndrewACNP1 @ahmednagui @yasiralthubaitiRadiology Signs
Although an elevated osmol gap is a potential early surrogate marker of toxic alcohol poisoning, it is neither sensitive nor specific.Bryan D. Hayes
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