Jonathan Adrian, MD

Why do we need to target a lower SpO2 in patients with COPD? - A mini thread 🧵 (1/7)

@FPLKarim_ @FPLUpdates_Tips Already have him 🤩

James Garner is currently ranked 8th for total points among midfielders 💥 He’s also hit DEFCON 8 times this season 🛡️ Garner could be a nice punt with set-piece duties, a budget price, and these upcoming fixtures ⤵️

@FPL_Brandon Virgil in for Salah. CoVar could not have worked better for me this week 🤝

Free Hit Gameweek 13 Review 🔥 Points: 82 (84 if Danso's DefCon added) Rank Update: 117k → 11,612 (+90.12%) GW Rank: 7,284 Chips Left: Triple Captain My best ever gameweek rank and I think these might be the biggest back to back gameweeks I’ll ever have. I’ve gone from 511k → 11,612 in just two weeks. Earlier in the week I wrote a long tweet about CoVar and explained that my aim with this Free Hit was to increase my exposure to luck and risk through that strategy. The tweet blew up and I know a lot of you used CoVar as well and it paid off. What a feeling and what a week, moments like these are why we play FPL. Let's see those Free Hit scores!👇🔥

My brilliant med student asked me to explain correlation, causation, confounding &collider bias. I used the following ex… so sharing here in case anyone finds it helpful! PS -I have learned much from @dnunan79 @Catalogofbias - a great resource for EBM. hopefully he approves😅

5. I’m applying to specialty training Deciding between an F3 year and specialty training was an easy choice for me. The non-training job market looks grim, and full-time locum work isn’t an option because I need a visa. I’m going all in on a specialty training post next year.

4. I bought a car A blue 2010 Ford Focus with 73k miles on the clock that I’ve grown to love. I bought it from a dealer with a warranty and a new MOT. Drives well and reasonably cheap to insure. Hopefully easy enough to sell on when I decide to upgrade.

🏥 Life updates 3 months into my standalone FY2 year 1. I’ve become much more comfortable in my role and feel confident managing most cases. I know when to escalate and can pace my clerk-ins smoothly. Most importantly, I’ve learned I don’t have to get everything right.

@thelasthazel I never totally understood the fuss with NHS staff shortages until I became a part of the NHS. My hospital has no middle grades and it’s been like that for years. We have 2 on-call medical SHOs & 1 F1 on nights. We are always 2 simultaneous emergencies away from total carnage.

@adrnjonathan It must be very stressful though but I don’t understand why all of responsibility has to be on your shoulders? Why there are no regs?

How my first week as an FY2 felt like (I’m new to the NHS) - Like I’m demanded to magically know how to do my job instantly - Like a civilian being placed in the middle of a war-zone - Like I’m expected to go from level 0 to 100 in a day

@f_sarasw For the first few months at least (I hope), until I understand the system & job description. It’s a problem of understaffing that they are unable to provide us with enough orientation. That’s my main issue, not the system nor the welfare.

@drkeithsiau Raynaud’s phenomenon 👉🏽 Part of CREST syndrome (limited scleroderma) 🥛 Calcinosis cutis 🥶 Raynaud’s phenomenon 😖 Esophageal dysmotility → reflux → epigastric pain 👋🏽 Sclerodactyly 🕷️ Telengiectasia 👁️Also causes sicca (dry eyes) (+) anti-centromere antibodies

Seen in a patient with dry eyes and abdominal pains. What’s the diagnosis?

@drkeithsiau Now that’s brilli-ant! 🐜

Has anyone seen this technique being used to close wounds? x.com/i/status/17976…

And that’s a wrap for cardiology! 🫀It’s gloomy where I’m at but I hope you all have a wonderful Sunday & week ahead 🙌🏽

10. AV node blocking agents ➡️ ABCD 🤨 Adenosine, amiodarone 🐢 Beta-blockers 🥛 Calcium-channel blockers 🐕 Digoxin

10 CARDIOLOGY mnemonics to help you memorise pearls for board exams and clinical practice – A thread 🧵 #MedTwitter #MedEd