Andrew Sanchez

📌 See below for my collection of: - Tweetorials for Diagnosis❓ - Case Challenges❗️ - @CPSolvers Presentations ♥️ docs.google.com/spreadsheets/d…

We are so excited to welcome to our @BIDMC_IM 2026-27 Intern Class to @BIDMChealth! This exceptional class represents 46 medical schools nationwide and they bring strengths in global health, medical education, QI, research and beyond. We can't wait to see them shine next year! 🌟

Looking forward to meeting all the incoming @BIDMC_IM interns in a few short months! 🙌

❗️Clinical Reasoning Image Challenge❗️ Middle-aged human presented for atraumatic chest/abd pain, found to have large ecchymoses over that site (photo 1). Incidentally, CT also showed findings of photo 2. Diagnosis?

Iron deficiency symptoms precede anemia because the body prioritizes red cell production — other tissues become iron-deficient first.

@RahulPottabath1 Lytic bone lesion, nice!

@ASanchez_PS I am seeing an homogenous mass around the right paraspinal area, infiltrating the bone. Wondering if it could be any soft tissue sarcoma???

@davserantes What I was thinking … IgG level almost 3000. Light chain ratio slightly off. Will update when SIFE comes back

@ASanchez_PS Was thinking about AL amyloidosis

@davserantes Very close

@davserantes Very nice. No but the coags are normal

@BraydonDymm IVT > IVIG

Think about it with malnutrition, prolonged vomiting, bariatric or GI surgery, malabsorption, and critical illness. If you suspect it at all, give thiamine promptly. It's cheap and harmless!

March 17th: A patient comes in confused, staggering, and with nystagmus after days of poor intake and heavy drinking. Everyone sees intoxication, but let's take a closer look. What neurologic diagnosis do you not want to miss?

@ASanchez_PS pubmed.ncbi.nlm.nih.gov/947688/

@RodrigoPLCosta Thank you for sharing! Patient's lesions were painless

@ASanchez_PS osler nodes have more inflamation (red, tenderness) and appers lately. Janeway appears early and are petechial and painless

Following-up! Final findings: - TEE w/ aortic valve vegetation - No BCx were drawn on admission, so BCx ⊖ after 72hr of CTX+azithromycin for "pneumonia" - Skin bx w/ thrombotic vasculopathy, no vasculitis, culture ⊖ Dx = presumed IE c/b Janeway lesions!

@4donjohn x.com/ASanchez_PS/st…

x.com/annkumfer/stat… - There are other causes of a monoclonal M spike - SPEP does not determine the type of immunoglobin and associated light/heavy chain causing the M spike.

@ROKeefeMD @Mark_Heslin @MadellenaC @AdamRodmanMD If you have CME leftover it's fairly inexpensive conference, also starts at 8pm EST so can watch after shift 😃 I'll be Zooming in!

@ASanchez_PS @Mark_Heslin @MadellenaC @AdamRodmanMD hell of a lineup!

Conference invite for my Diagnostic Excellence friends! ✨ You will recognize some faces ... @Mark_Heslin @MadellenaC @AdamRodmanMD #DxEx

Renal hemosiderosis in paroxysmal nocturnal hemoglobinuria - Kidney International kidney-international.org/article/S0085-…

Our study of AMIE at @BIDMC_Medicine is out! You can read about what we did in posts from my co-authors (including the Google post below). But I wanted to talk about some background for this study, and what I think are most interesting findings. 🧵⬇️ x.com/GoogleResearch…