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Reposted by Zaven Sargsyan

David Juurlink @davidjuurlink.bsky.social · Apr 10

Let's talk about using carbapenem antibiotics in patients with valproic acid (VPA) poisoning

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Zaven Sargsyan @sargsyanz.bsky.social · 10h

Any tips / anticipatory guidance about people on VPA at therapeutic doses who develop an ESBL infection?

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Reposted by Zaven Sargsyan

David Juurlink @davidjuurlink.bsky.social · 13h

PSA: When a naturopath recommends chelation “to remove the metal from your body,” that is exactly what you should not do.

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Zaven Sargsyan @sargsyanz.bsky.social · 13h

Polycythemia falsa

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Reposted by Zaven Sargsyan

Emily Fridenmaker @emilyfri.bsky.social · 16h

Discussing this article for our QI didactic on Monday. So good.

journal.chestnet.org/action/showP...

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Zaven Sargsyan @sargsyanz.bsky.social · 18h

Also I love the thirsty evacuated container as the image of “decreased ascites formation” 😄

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Zaven Sargsyan @sargsyanz.bsky.social · 18h

Great read, thanks yall.

I’ve always been struck by how some folks have a lot of synthetic/hepatocellular dysfunction but little portal hypertension.. or vice versa.

Good argument that the relative contributions of each to MELD-Na might be actionable in this context..

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Zaven Sargsyan @sargsyanz.bsky.social · 18h

Back to the future

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Reposted by Zaven Sargsyan

Juan Carlos Q Vélez, MD @juancarlosqvelez.bsky.social · 21h

Bold much-needed perspective by @sarahsanghavi.bsky.social et al about revisiting TIPS in the context of kidney disease, particularly in some cases of #HRS at #Kidney360 journals.lww.com/kidney360/ab...

journals.lww.com

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Zaven Sargsyan @sargsyanz.bsky.social · 2d

And their jugular veins are distended to the jaw even when they’re about to die of resultant septic and hypovolemic shock

Reposted by Zaven Sargsyan

Dr. Longissimus @drlongissimus.bsky.social · 2d

Bats get descending cholangitis

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Reposted by Zaven Sargsyan

Atheendar Venkataramani @atheendar.bsky.social · 2d

I did a five month experiment where I signed off all social media. I felt smarter + less angry and distracted.

Alex de Campi @alexdecampi.bsky.social · 3d

A thought I keep having: what if I just log off all social media and subscribe to a few paper magazines and newspapers instead

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Zaven Sargsyan @sargsyanz.bsky.social · 3d

Congrats on 500, @thecurbsiders.bsky.social !

The episode was good, too. Would recommend it to folks wanting some updates on COPD, which there are many.

Even thymic stromal lymphopoietin made an appearance @paulnwilliams.bsky.social

thecurbsiders.bsky.social @thecurbsiders.bsky.social · 3d

🎉 We’re celebrating our 500th episode with a GIVEAWAY! 🎉

That’s 500 servings of knowledge food for your brain holes 🧠🍽️ — and we couldn’t have done it without YOU! Use the link below for more details! 👇🏼

www.instagram.com/p/DPejD3xEek...

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Reposted by Zaven Sargsyan

🧛VÆmpiric @empiricgame.bsky.social · 3d

Packing a lunch is not enough. You also need to bring it to work.

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Zaven Sargsyan @sargsyanz.bsky.social · 3d

I've been thinking recently about how we heavily from ACEi -> ARB over the last 15 years, and that drug-induced chronic cough became much less common.

But now we've gone / we're going ARB -> ARNI for a lot of patients. Back on the bradykinin train. Drug-induced cough probs increasing again.

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Reposted by Zaven Sargsyan

Paul Williams @paulnwilliams.bsky.social · 3d

Hey #MedSky! Anything new in the world of chronic cough? New guidelines, terms, treatments? Still intranasal fluticasone for all?

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Reposted by Zaven Sargsyan

Edward Nirenberg @enirenberg.bsky.social · 3d

This serves absolutely no purpose other than to reduce vaccine uptake:
www.reuters.com/business/hea...

www.reuters.com

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Reposted by Zaven Sargsyan

Atheendar Venkataramani @atheendar.bsky.social · 3d

Why do people think this website is good? No one is engaging. There is little discussion. It's just all of us saying stuff in parallel.

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Reposted by Zaven Sargsyan

josh farkas 💊 @pulmcrit.bsky.social · 5d

Updated the IBCC DKA chapter 🍭

Biggest changes were organizational, there is now a pretty clear & streamlined 8-step guide

Biggest content change was a rewrite of the definition of DKA (but - spoiler alert - the definition remains unclear & controversial)…

emcrit.org/ibcc/dka/#top #EMIMCC

a woman in a checkered shirt says way too much sugar in a kitchen

ALT: a woman in a checkered shirt says way too much sugar in a kitchen

media.tenor.com

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Zaven Sargsyan @sargsyanz.bsky.social · 5d

Thanks for this, learned a lot.

Another benefit of IBCC: easier to fix typos!

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Reposted by Zaven Sargsyan

josh farkas 💊 @pulmcrit.bsky.social · 5d

Fresh blog: Six pearls on heparin-induced thrombocytopenia (HIT) in 2025

💎 enoxaparin causes 10x less HIT than UFH

💎 HEP score

💎 approach to intermediate 4T score?

💎 rising use of DOACs

💎 autoimmune HITT

💎 IVIG for immediate inhibition of HIT antibodies

blog emcrit.org/pulmcrit/hit... #EMIMCC

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Zaven Sargsyan @sargsyanz.bsky.social · 6d

What's even the point of getting enough sleep if you're not gonna flex about it

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Reposted by Zaven Sargsyan

josh farkas 💊 @pulmcrit.bsky.social · 11d

"consensus" guideline on the management of DKA & HHS

with ZERO input from:
- anyone in emergency medicine
- anyone in critical care
- anyone in hospital medicine

the guidelines (published in 2024) contain many antiquated practices and big errors... 🧵#1/3 #EMIMCC

pubmed.ncbi.nlm.nih.gov/39052901/

https://diabetesjournals.org/care/article/47/8/1257/156808/Hyperglycemic-Crises-in-Adults-With-Diabetes-A

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Reposted by Zaven Sargsyan

Paul Williams @paulnwilliams.bsky.social · 7d

While this day mostly did its best to hurt me, two different patients made a point to say they were grateful for how thorough I was, and a hospitalist I never met told me, “I read your progress notes, and you’re some kind of saint,” so it’s kind of a wash.

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Zaven Sargsyan @sargsyanz.bsky.social · 7d

A lot of asterixis can be observed without elicitation.

Holding the phone. Holding a fork. Holding themselves up in bed—whether with arms or abs—while you listen to their lungs.

m.youtube.com/shorts/9kkV8...

Uremic Asterixis

YouTube video by André Mansoor

m.youtube.com

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