@DavidGSnider

General internal medicine resident @ University of Manitoba

 Winnipeg, Manitoba
Joined December 2019
  • Tweets242
  • Following609
  • Followers55
David Snider retweeted
Aisha Shaikh
@aishaikh21 May 2021
💥What is Monoclonal Gammopathy and when does it’s presence indicate presence of cancer? 💥What is MGUS and MGRS? #Onconephrology 1/
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David Snider retweeted
Josh Briscoe@jcbriscoe128 Mar 2021
There's been good discussion about the relationship between palliative care and dying recently. Some thoughts of mine... 1/ #hapc #hpm
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David Snider retweeted
Elliot Tapper@ebtapper28 Mar 2021
1/ HOW long do you live with #cirrhosis? WHERE did MELD Score come from? WHAT is a "TIPS"? ARE you ready for re-#tweetorial #livertwitter #medtwitter #meded
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Nephro attending: You'll always be surprised at what an NSAID will do to the kidneys in a volume depleted state
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Screening in ED o/n: How to screen in 1-2min - referral reason - HPI: substrate (function, relevant comorbidities), CC + tempo of illness -> severity at 1st medical contact (VS + pertinent labs/rads) -> tx(s) and responses - your exam 1/
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2/ - provisional dx with key supporting features and focused ddx focused on life-threatening, treatable, and common conditions - dispo (admit vs. not, ward, tele, ICU) w/ comment on anticipated course
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3/ - plan for each major issue: 1) monitoring, tx(s) w/ goals 2) diagnostics (bloods/fluids/imaging) - GoC and SDM/contacts #MedEd #FOAMed
In neuro clinic: - role of EEG in seizure is to delineate pattern of epilepsy, prognosticate first time seizure and rule out NCSE - if unprovoked seizure, normal neuroimaging and equivocal EEG, repeat once with sleep-deprived EEG and if nothing don’t tx with AED 1/
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2/ - if two unprovoked sz >24h apart, EEG isn’t going to change management so don’t order - it’s possible to get secondary migraines (I.e. AVM associated) so there’s a role for neuroimaging as you may be able to cure it - abn neuroimaging and/or EEG in setting of sz warrant AED
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3/ - thunderclap headaches top 3 ddx: SAH, RVCS and pituitary apoplexy and best imaging modality is CTA whereas MR imaging tends to be better for parenchymal and meningeal lesions #MedEd #FOAMed
In cardio clinic: - pre-eclampsia in women with chest pain signals increased risk of developing IHD - normal MPI signals ~1% risk of cardiac event in 5y - perindopril is OD (in IHD and HFrEF), greater antihypertensive effect vs. ramipril and comparable in price #MedEd #FOAMed
David Snider retweeted
Aisha Shaikh
@aishaikh4 Mar 2021
💥 Tweetorial on ‘Cryoglobulinemia’ ⚡️What are Cryoglobulins? ⚡️When should a clinician suspect Cryoglobulinemia & Cryoglobulinemia vasculitis? ⚡️How to establish the diagnosis? ⚡️Significance of Rheumatoid Factor 1/ @GlomCon #Onconephrology
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1/ Typical clinical reasoning exercises start with patients who give symptoms —> other historical information —> one-time physical exam —> one-time labs/imaging (sometimes more) —> diagnosis
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David Snider retweeted
CORE IM@COREIMpodcast3 Mar 2021
1/ Good evening, #MedTwitter, and welcome to the latest installment of #ReadingRoom! Our patient is about to head down to the scanner, and we need to protocol this CT with IV contrast. Of the options below, which ones would you want with IV contrast? Why?
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In endo clinic: - think of TGs separately from other lipids: they are fuel for muscle and adipose tissue and travel in blood via chylomicrons - insulin facilitates LPL which allows uptake of TGs into these tissues - insulinopenic states generally have high TGs 1/
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2/ - DKA pts generally have high TGs - insulin, fibrates, and lifestyle all can lower TGs - I’ve had two recent cases with acute pancreatitis 2/2 hypertriglyceridemia that both responded beautifully to IV insulin #MedEd #FOAMed
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3/ - I say all this because when I order a lipid panel I never now what to think of the TG level and how it pertains to the other cholesterol levels - now I think of them as a separate and somewhat unrelated entity
In ID clinic re: UTI - relapse (not recurrent) is return of sxs within 2 weeks s/p abx - ½ of simple cystitis get better on their own - pain with defecation can signal prostatitis - ask about concurrent constipation, sexually activity and dehydration #MedEd #FOAMed
In heme clinic: HAS-BLED used for bleeding risk in pts being tx'd for VTE, but remember the HAS-BLED was studied in older pts and may overestimate risk of bleeding. #MedEd
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David Snider retweeted
André Jefremow@anjefus28 Feb 2021
Let's do a new tutorial GI-Bleeding for non-endoscopists #MedTwitter #GITwitter #livertwitter #ICU #FOAMed @stevenbollipo @drkeithsiau @ebtapper @jaumebosch9 @GI_Pearls @DrHarryThomas (these are endoscopists)
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