optimus maximus

this

@schowardjd erythema nodusum

An adolescent girl w/ severe atopic disease (asthma & allergic rhinoconjunctivitis) well controlled on dupilumab (Dupixent®️) developed, after ~1 yr of tx, bilateral, tender erythematous nodules on the extensor lower legs. What’s your diagnosis❓

Brugada Syndrome: The "Silent Killer" of the Young 1. Brugada Syndrome is one of the most common causes of Sudden Cardiac Death (SCD) among young, otherwise healthy individuals. It is a genetic "electrical" problem of the heart that often strikes during sleep or rest. 2. The 3 ECG Patterns Think of these as the "Shapes of Danger" on an ECG (specifically in leads V1-V3): • Type 1: Coved Type The Look: A steep, downward slope (like a cliff or a wave). Clinical Sign: >2mm ST-elevation ending in a negative T-wave. This is the most diagnostic and dangerous pattern. • Type 2: Saddle-Back Type The Look: Resembles a horse saddle. Clinical Sign: >2mm ST-elevation with a positive or biphasic T-wave. • Type 3: The "Subtle" Pattern The Look: Can look like either Coved or Saddle-back but is less pronounced. Clinical Sign: J-point elevation <2mm and ST-elevation <1mm. 3. Management & Prevention The goal is to prevent Vicious Arrhythmias (like Ventricular Fibrillation) and subsequent cardiac arrest. • Primary Treatment: ICD (Implantable Cardioverter Defibrillator). This is the gold standard for high-risk patients to "shock" the heart back into rhythm if it stops. • Avoid Triggers: Fever: Must be treated aggressively (fever can "unmask" Brugada and trigger arrest). Certain Medications: Avoid specific sodium channel blockers and antidepressants. 4. Remember • Demographic: Frequently seen in young male. • The Trigger: Events often occur at night (nocturnal) or during a high fever. • Syncope: A history of fainting (syncope) in a young person with these ECG patterns is a massive "Red Flag." • The ICD Rule: If the patient has had a prior cardiac arrest or has the Type 1 pattern with symptoms, think ICD immediately. #MedTwitter #FOAMed #MedX

Sometimes as a woman you don't understand whether you are hormonally sad, menstrually sad, ovulationally sad, seasonally sad or actually sad

@PenduProfessor 🌺🙏🏽

@khannaa Hugs Khanna Saab 🙏

Seven years this year, Mummy. Not one day has passed without thinking of you. Not one. I think about the food you used to make me whenever I asked. Something so small, but I would give anything to sit at that table again. The way you said my name. I cannot explain it. I just know I have never heard anything like it from anyone else. You used to laugh at my jokes, even the stupid ones, and your laugh was so free, so real. I miss that laugh. And your hand on my head. Mummy, nothing in this life has ever felt like that. Nothing has come close. Every day something brings you back to me. A smell. A song. A plate of food. A quiet moment. You are still here in all of it. I miss you. More than I know how to say. Until we meet again, I will carry you with me. Every single day.

@_aperfectmess_ 🌺🙏🏽

May you find clarity in every thoughts. #Gratitude #Sunrise

This @munnas.45/post/DW5pY8_CBWO?xmt=AQF0slv_qwWTDi-mNtShkkUDBHes_K9FmJQ8RrnCAy1cJ_2SX1wVjHtOFkg0UowiZIAd_Hgc&slof=1" target="_blank" rel="nofollow noopener">threads.com/@munnas.45/pos…

@Geeky_Foodie 🌺😍

Imagine this on a train in India! People would be jumping, screaming, crying even.. some would be pulling it’s tail and ears without knowing how much it hurts them.. some would get a kick out of just kicking the dog.. adults much more than children, stressing and making the poor baby anxious enough to… pass on the trauma and anxiety of facing humans for generations of dogs to come.. Pet /animal handling needs to be a part of the school syllabus!

definately

@neurodocente 🙌

🥂I’ve never had a single drop of alcohol in my life, and I’ve never smoked or used any toxic substances either. Of course, I’ve been in social settings where people drink, and when I’ve been offered something, I’ve always politely said no, what I’m thankful for is that the respect has always gone both ways, no one has ever pushed me or tried to persuade me. I remember that once, at a work lunch, a woman told me, “It’s a good thing you don’t drink. I used to be like you, but when I was your age, I started drinking because of social pressure. I went to gatherings where people pushed me into it” I was grateful to hear that, because I realized I had never gone through that, and at this point in my life, even if I did, I already know what I’d do. I respect whatever each person chooses to do with their life, just as I’m grateful when people respect my decisions. But a lot of this isn’t just because of me. I owe much of it to my dad. He didn’t drink, and he never brought friends home to eat or drink, knowing he had three daughters to protect. The power of example is real.

Kussmaul’s sign in constrictive pericarditis Increased JVP on inspiration (instead of falling) Why? Rigid, non-compliant pericardium 👉🏻RV can’t expand with increased venous return 👉🏻blood “backs up” into JVP. #MedX

@Coffeehudigi time?

#MedTwitter Tomorrow doing a podcast on Hybiz TV show about Obesity/ Weight loss drugs. Ask your questions!

Medivis's SurgicalAR platform for assisting neurosurgeons during surgery. This received FDA clearance in Dec 2025.

🚨 ECG breakdown 🔻Rhythm & Rate Sinus rhythm Rate 85- 88 bpm P before every QRS, constant PR → no AV block 🔻Axis:- Normal axis (QRS positive in I & aVF) 🔻Anterior Leads (V1–V6) Diffuse ST elevation (V1 → V6) Morphology: convex / straight (“tombstone” tendency in V2–V4) Indicates large anterior wall involvement This is not focal → suggests proximal lesion 🔻High Lateral Leads (I, aVL) ST elevation in aVL > I Interpretation: Injury vector directed upward & leftward Strong pointer toward proximal LAD (before D1) 🔻Inferior Leads (II, III, aVF) ST depression present III > II > aVF Reciprocal changes Vector moving away from inferior wall Interpretation: Supports LAD occlusion against left main / triple vessel ischemia, where aVR STE is expected. 🔻Putting It All Together Diffuse anterior STE (V1–V6) High lateral STE (aVL > I) Inferior reciprocal STD (III > II) No aVR STE ✅Proximal LAD Occlusion Myocardial Infarction (pLAD OMI) 🔻Why proximal LAD? Involvement of: Septal (V1–V2) Anterior (V3–V4) Lateral (V5–V6, aVL) Indicates lesion before S1 + D1 branches #MedX #ECG

@daoo100 Cirrhosis with portal hypertension -most common cause of tense ascites.

@SameerYogi14 @docakx @IhabFathiSulima @Dr_Shiv_kumar_ a

A 40-year-old female with a history of chronic sun exposure presents to the OPD with brownish pigmentation on the face as shown in the image. What is the diagnosis? A. Melasma B. Freckles C. Basal cell carcinoma D. Melanoma #Medx26 @docakx @IhabFathiSulima @Dr_Shiv_kumar_ @daoo100

I find that interesting because there are still people willing to meet an idea where it was originally written, rather than only where it becomes easiest to consume and that actually counts for more than it seems, especially when language carries nuance and intellectual tone.

peak toxicity

@Doctors_GUILD doxy

Preferred treatment for scrub typhus: A. Ceftriaxone B. Azithromycin only C. Doxycycline D. Amoxicillin

@ESC_Journals @Phiso_de @TJ_Yeo @aayshacader @BoldiKovacsMD @sukritibanthiya @ANazmiCalik @O_Azizy_MD @saramoscatelli7 @EHJCREiC c

ECG Challenge: ST Elevation in Critical Illness—A Diagnostic Dilemma ow.ly/yG4g50YFhhn #EHJCaseReports @Phiso_de @TJ_Yeo @aayshacader @BoldiKovacsMD @SukritiBanthiya @ANazmiCalik @O_Azizy_MD @saramoscatelli7 @EHJCREiC #CardioX