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Zaven Sargsyan @sargsyanz.bsky.social · 1d

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 · 1d

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 · 2d

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 · 2d

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 · 2d

🎉 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 · 2d

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

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Zaven Sargsyan @sargsyanz.bsky.social · 2d

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 · 2d

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 · 2d

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 · 4d

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 · 4d

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 · 5d

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 · 10d

"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 · 6d

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 · 6d

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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Zaven Sargsyan @sargsyanz.bsky.social · 6d

An intervention with a NNT of 20 for mortality costs negative dollars, involves taking fewer pills, and has 0 side effects.

The intervention is stopping aspirin in patients with chronic CAD (including stents >6 mo old) who take an oral anticoagulant.

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Reposted by Zaven Sargsyan

Eric Strong @ericstrong.bsky.social · 8d

Strong Medicine's latest:

A deep dive into RFK Jr, including his bizarre beliefs about science (his antivax beliefs are relatively normal compared to everything else), his disturbing personal history, and a rundown of the most horrible things he done so far as HHS secretary.

youtu.be/s2wzQUNkQ00

RFK Jr. Is Killing America

YouTube video by Strong Medicine

youtu.be

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Zaven Sargsyan @sargsyanz.bsky.social · 8d

💯

And there are conditions with even more non-specific symptoms, even lower-risk tests, even bigger effect size of treatment—eg adrenal insufficiency or pheo. Where testing threshold & usual pretest prob is very low and positive result could/should be not only <100%, but small minority, like 10%.

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Reposted by Zaven Sargsyan

Emily Moin @emilymoin.com · 9d

A “final notice” from a predatory journal? Don’t threaten me with a good time

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Zaven Sargsyan @sargsyanz.bsky.social · 9d

Pap-ular, I know about pap-u-u-lar

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Zaven Sargsyan @sargsyanz.bsky.social · 10d

Similarly: if your entry point into considering a CT is to rule out PE but you‘re on the fence for some reason, remember that the “incidental” look at the parenchyma, mediastinum, heart, chest wall often shows the alternate dx.

“No pulmonary embolism. However….” is dictated on the daily.

josh farkas 💊 @pulmcrit.bsky.social · 10d

if you’re getting a CT chest for a critically ill patient in respiratory failure of unclear etiology, it should be a CT angio to evaluate for PE (& other stuff)

sometimes being thorough is more effective than being smart

also, contrast allows evauation of cardiac chamber size & IVC reflux

a man in a black shirt is standing in front of a fire and the words do it

ALT: a man in a black shirt is standing in front of a fire and the words do it

media.tenor.com

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Zaven Sargsyan @sargsyanz.bsky.social · 11d

There are many things that look scary despite being benign, but Schmorl’s nodes take the care.

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Zaven Sargsyan @sargsyanz.bsky.social · 13d

Lactate does not equal bolus

shmpublications.onlinelibrary.wiley.com/doi/10.1002/...

Things We Do for No Reason™: Using lactate as our resuscitation guide in sepsis

Click on the article title to read more.

shmpublications.onlinelibrary.wiley.com

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Reposted by Zaven Sargsyan

Paul Williams @paulnwilliams.bsky.social · 13d

Please help, #MedSky! I’m giving a talk on things we do for no reason. Of course Colace, PRN anti hypertensives, and AMA discharges will make the list. Sliding scale insulin monotherapy while inpatient will be on there.

What other TWDFNRs do you love?

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