Kang Xiao Zhang

Updates in #HospitalMedicine, Part 3 #Metformin #Aspirin #Calcium #Albumin #Cirrhosis #Steroids #WBC #CAP #Pneumonia #Apixaban #VTE #GPT #BetaBlockers

This is a great talk on how to speak that more or less also summarizes “how to teach” #MedEd

🔥Just published 🔥 ESCMID Clinical Guidelines on the Evaluation and Management of a Reported Antibiotic Allergy #IDXposts clinicalmicrobiologyandinfection.org/article/S1198-…

Please do not do that research: 10 topics that do not need to be studied open.substack.com/pub/sensibleme… via @adamcifu

Best of 2025 in Hospital Medicine Expanded in video with more details with paired EBM critical appraisal pearls If you prefer to read a rapid fire summary, check out my post below one person described it as the "best summary of major articles...! you beat all my NEJM Journal Club and JAMA subscriptions hands down"

@ebtapper Love this and have shared it with my trainees. Was told by a hepatologist to never use IV Lasix since oral absorption should be preserved vs CHF where there is gut edema. and iv lasix can precipitate HRS, can you comment?

Rounding for the last two weeks I took a lot of transfers and consults for people who were not doing great on lasix mono therapy There is a reason for that Spread the word

🧵 The Cardiac Function Curve — why it misleads (Part 1) 1/ The cardiac function curve is one of the most recognisable images in physiology. Unfortunately, it’s also one of the most misdrawn, mislabelled, and misunderstood. Let’s redraw it — and see what it really tells us about the circulation. #MedX #FOAMed #physiology

1️⃣ Some patients with severe venous congestion have almost no oedema — and that’s confusing at first. It only starts to make sense once you unpack the physiology. 👇

What: Physical diagnosis course When: December 2-4, 2025 Who: Any of you anywhere in the world you might be Where: Virtual Why: We will have fun and learn together - 3 hours per day for 3 consecutive days Sign up here: physicaldiagnosispdx.com/sign-up-for-ma… More details at pdxpdx.com

I hear clinicians say the physical exam is dead.☠️ This is just not true 🛑 Here are the 10 most important clinical exam findings in the ICU A 🧵 (and some things you can probably stop doing...) #medtwitter #foamed

For all the new medical students starting this fall there are 10 lessons they don’t teach in medical school (but should) @ross_prager thesgem.com/2025/06/sgem-x… @SchulichMedDent @WesternU

You've probably heard "don't give lactated ringers because it raises lactate" This statement is ~98% false, but there's one crucial practice-changing fact that you need to know. A 🧵 all about lactic acid and lactated ringers! 1/

🆕🔥 State of the art review article @CMIComms 🌟s @DrToddLee @DrEmilyMcD Approach to Clostridioides difficile Diarrheal Infection ( CDI) Excellent discussions about the management of CDI #IDXposts #mustread sciencedirect.com/science/articl…

@DrStevenTChen Thank you. Very helpful.

For better or for worse (worse), MEASLES are back, so here's a #tweetorial on recognizing this once thought eradicated disease. MEASLES: a tutorial! #dermtwitter #dermX #medtwitter #medX #MedEd 1/

🧵1/ Last year, a thoughtful reply to our @JAMA_current article sent me down a rabbit hole on CVD prevention. Should statins be prescribed less or more often? Available OTC? Added to the water supply?? Let’s talk trials, thresholds, and tradeoffs!

@ebtapper Are you routinely doing PJP prophylaxis for those for who are steroid responders?

Please - if you are going to use a steroid to treat Alcohol-associated hepatitis - please do not send a patient on a wild goose chase searching for a pharmacy that carries prednisolone Prednisone is fine

A great study answers a clinical question And this is a great study Does one kind of steroid help patients with alcohol-associated hepatitis more than the other? No journals.lww.com/hepcomm/fullte… @HepCommJournal @juanpabloarab

The second edition of #FrameworksForInternalMedicine is available now

why spirinolactone is more effective than loop diuretics in cirrhosis patients ? A 🧵 from burton rose #nephtwitter #MedX 1/5