Rheuma Doc

Steroids 2 mechanisms of action 1/ Genomic (activates @ 7.5mg-30mg Pred/day). Ceiling of saturation > 50mg. Limited additional anti-Inflammatory benefit beyond & ⬆️ Adverse 2/ NonGenomic. Act @ 100mg, Max sat 250-500mg & Less S/E as Shorter ⌛️ Less Is More! Great Slide 👇

Gout on steroids.. #MedTwitter #Rheumatology

@holylipss 😔

How does it feel to lose someone you love?

Max Dowman is IT!

@pokemondealsuk Same old… we are left with nothing.

It looks like prismatic booster bundles have dropped at the pokemon center US! Unsure about the UK

Efficacy and Safety of Obinutuzumab in Active Systemic Lupus Erythematosus #SLE #Rheumatology 👇 nejm.org/doi/full/10.10…

No, Its not Lupus.

@donrobbie836 @pokemondealsuk What code did you use?

@pokemondealsuk The 15% EUIC discount code is coming in clutch

I was right 😅

@pokemondealsuk Anything -UK?

Prismatic Evolutions Premium Figure Collection & Flareon Plush Bundle has dropped at the pokemon center US

The Gout Universe #Rheumatology #MedTwitter

Ouch! Trauma call… #MedTwitter

VEXAS Review #Rheumatology #MedTwitter 👇

Azathioprine [thiopurines] ⬆️ risk of Intra-hepatic Cholestasis of pregnancy 🚩Safe but not risk free ➡️Use lowest effective dose ➡️Monitor metabolites if access [6-TGN & 6MMP ratio] ➡️Monitor for pruritus, rising bile acid, & LFTs 💊 Switch to tacrolimus if shunting or ICP

#Sjogrens autonomic neuropathy clinical features and treatment options. It’s complex! ➡️ Can try Non-pharma & education initially 💊If Severe → IVIG or Rituximab ➡️Orthostatic & BP↓ → midodrine fludrocortisone | IV saline ➡️Tachycardia →β-blockers| ivabradine |pyridostigmine

Paper from lancet, 3 months of romosozumab followed by 9 months of denosumab was non-inferior to 12 months of romosozumab in increasing total hip BMD #Rheumatology #MedTwitter #Osteoporosis thelancet.com/journals/landi…

Neuromyenteric enteropathy - the ‘brain in the guts’ [POTS, gastroparesis, weight loss etc]. Dysfunction of this vital system may precede other autoimmune clinical manifestations observers in Sjögren’s or SLE/SSc #Rheumatology #MedTwitter

Ref ajkd.org/article/S0272-…

Paper reviewing the current and future direction of the treatment of #lupus nephritis #SLE #MedTwitter reference👇

The wide spectrum of #Myositis specific antibodies and their clinical phenotype.. #Rheumatology #MedTwitter