Alarmed

@PJaseja reddit.com/r/medicalschoo…

Did it for primary amenorrhea Hypothalamus - Kallman, trauma, infiltrative disorders, Pituitary- Adenoma, tumors Ovary- Turner, Sweyer Uterus - AIS, MRKH Vagina- Agenesis, TVS, Imperforate hymen Add on - adrenal - 17 alpha deficiency

@marcusbrutus69 @thenerdnxtdoor2

@Alarmeddd @thenerdnxtdoor2 rmsf is centripetal na? Upar toh likha tu ne

Patient develops rash starting on wrists and ankles → spreads to trunk. This history alone raises the suspicion for one particular disease. Rocky Mountain Spotted Fever Remember to rule out other conditions that involve the palms and soles: Syphilis and Coxsackievirus

🧠 Vasopressors in Septic Shock: Are we still treating numbers instead of patients? A new review in Intensive Care Medicine challenges how we think about vasopressor therapy in septic shock. 🧐The uncomfortable truth We often believe vasopressor management is straightforward: ➡️ Start norepinephrine ➡️ Add vasopressin if needed ➡️ Escalate to reach MAP targets But reality is far more complex. ⚠️ What the paper clearly highlights 1️⃣ Norepinephrine is first-line—but not “one-size-fits-all” Strongest evidence base ✔️ BUT: massive interindividual variability Same dose ≠ same biological effect 👉 Dose escalation may reflect non-responsiveness, not underdosing 2️⃣ Vasopressin: logical, but not proven Added to reduce catecholamine exposure No consistent mortality benefit Possible signal if used early at lower NE doses 👉 We are likely using it too late and too blindly 3️⃣ Angiotensin II: physiologically appealing, clinically uncertain Improves MAP Reduces NE requirements No clear outcome benefit 👉 Probably works… but only in selected phenotypes 4️⃣ Hydrocortisone: underrated tool Reduces vasopressor requirements Likely improves vascular sensitivity 👉 Not just “adjunct”, but essential 🚨 The real paradigm shift This is the most important message: 👉 We are still practicing dose-based vasopressor therapy 👉 Instead of mechanism-based, personalized resuscitation 🧬 Why trials keep being “negative” Not because therapies don’t work. But because: We treat heterogeneous populations Without identifying: Adrenergic responsiveness Vasopressin deficiency RAAS dysfunction 👉 Wrong drug for the wrong patient = neutral trial 🔮 Where we are heading The future is clear: ✔️ Bedside assessment of vascular responsiveness ✔️ Functional hemodynamic phenotyping ✔️ Biomarker-guided vasopressor selection ✔️ Moving from MAP targets → perfusion physiology 🫀 Clinical take-home Start norepinephrine early ✔️ Reassess mechanism before escalating❗ Add vasopressin early, not late Consider hydrocortisone when NE escalates Minimize sedation → reduces vasoplegia 💬 My reflection We mastered how to push vasopressors. Now we need to master when, why, and in whom. 👉 The next leap in septic shock care will not be a new drug. 👉 It will be better patient selection. 📃Intensive Care Med doi.org/10.1007/s00134…

@thenerdnxtdoor2 Chicken pox spares palm and soles. Small pox is eradicated tho but yes it is centrifugal just like Rocky Mountain Spotted Fever

@Alarmeddd What about chicken pox and small pox?

@PJaseja Lmao I got it correct on 5th step. I'm embarrassed

New riddle today-Meningitis?🤔

@PJaseja It has centrifugal distribution, no? 🤔

@Alarmeddd What about scrub typhus rash?

@Peroneal_ Look at this once... you'll remember everything instagram.com/p/Ccc-upWhP6U/…

@Alarmeddd Yes and there's one more finding

Diagnose the condition. #NEETPG #INICET

@Peroneal_ Cobblestone mouth

His psychiatry videos too 🤌

@Alarmeddd Alll the best. You will remember everything. Be calm. Eat breakfast properly and stay hydrated!!!!

Finding the perfect summary table for knee exams only after getting cooked in my sendups viva. Pain 🫠 ©: FirstAid Step 1

@Peroneal_ Same tbh. Final exam tomorrow... hope this question gets asked cuz I spent 30 mins just memorizing this 😭

@Alarmeddd I hate this 😭

@DrAditya2935 Here's M7 btw 🫠 x.com/Alarmeddd/stat…

This is a good question. It’s a common misconception that AML is more common in dow It’s not. ALL is more common. But amongst AML - M7 is most common in down.

@DrAkhilX People with Orgasmic headache crying in the corner 🫠

Sexual activity can cure some headaches.

@PJaseja @stethoandpen Akinetopsia 😅

@stethoandpen Infections can't hit a moving target 😂

Stagnation leads to infection Either in medicine or in life !

@TheKoshurDoc Risk of aspiration. Hydrocarbons are contraindications to lavage

@Alarmeddd Thank you. Why is lavage avoided?

Why do children love to drink kerosene, and why is its poisoning common in children? Kerosene isn’t poisonous per se, but how can it turn deadly? Treatment?

Same image but enhanced with ChatGPT WHO classification of cystic echinococcosis (hydatid cyst) 🐛

@crazymed12 This is actually Brodie's abscess caused by staph aureus most commonly

@Alarmeddd Tb

Child with localized pain, minimal fever, normal/mildly raised ESR. Likely Diagnosis? Treatment?