Dr Toronto @drtoronto on GrepMed

Workup for Vitamin B12 and Folate Deficiency #Workup #VitaminB12 #Folate #Deficiency #FolicAcid #Diagnosis #Macrocytosis #MacrocyticAnemia #Algorithm

Causes of Vitamin B12 Deficiency - Cobalamin Decreased Intake Pancreas: Insufficiency Intestine: SIBO, Celiac disease, IBD, Lymphoma, Amyloidosis, Resection, D. latum Stomach: Pernicious anemia, Bypass/gastrectomy, H. pylori infection, B12 malabsorption, Gastritis Other: Medications (PPI, H2 blockers, metformin), Genetic - BWH Medicine Chiefs @BrighamChiefs #Vitamin #B12 #Deficiency #Cobalamin #differential #diagnosis #causes

$Approach to Thyroid Function Tests in the Evaluation of Hyperthyroidism • Low TSH, Low normal T4$

Approach to Thyroid Function Tests in the Evaluation of Hyperthyroidism • Low TSH, Low normal T4 → Possibly Central Hypothyroidism. unlikely subclinical hyperthyroidism. • Low TSH, normal T4 +/- T3 → Subclinical Hyperthyroidism: Work-up similar to hyperthyroidism as below. Can repeat labs 6 weeks after the resolution of pregnancy, critical illness, and dopamine agonists/octreotide. • Low TSH, high T4 +/- T3 → Primary Hyperthyroidism → Signs of symmetrically enlarged thyroid & ophthalmopathy → Graves' Disease → Confirm with TRAb → Radioactive Iodine Uptake & Scan • High or normal TSH, high T4 +/- T3 → Central (secondary) Hyperthyroidism → MRI Pituitary - Dr. Claire Brickson @crbricks #Hyperthyroidism #algorithm #diagnosis #endocrinology #TFTs #TSH #Interpretation

Comparison of Chronic Asthma and COPD Management 2016 - Dr. Eric Strong @DrEricStrong - Strong Medicine https://www.youtube.com/c/EricsMedicalLectures/ #Asthma #COPD #Comparison #Chronic #Treatment #Management #Pulmonary

Dropped Foot Gait - Paralysis of Dorsal Flexion of the Foot. When trying to walk the tip of the foot touches the ground and trips. To avoid this, he raises the lower limb sharply. It is found in lesions of the common fibular nerve, not allowing dorsiflexion of the foot. This type of gait is commonly observed in peripheral motor neuron disorders. When there is involvement of the common peroneal nerve, which causes flaccidity of the leg and deficit of the dorsiflexor muscles of the foot, the patient walks by raising the leg excessively, at the expense of energetic flexion of the thigh on the hip (Escarvante gait). via @tudodaneuro #DroppedFoot #Gait #Neurology #PhysicalExam #clinical #video

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Managing disclosure of gender dysphoria #Management #PrimaryCare #GenderDsyphoria #Gender #Dysphoria #BMJ

Thalassemia - Electrophoresis - Comparison Table In this disorder it is the defective production of hemoglobin that leads to microcytosis. The main types are the beta-thalassemia, alpha-thalassemia and Hemoglobin E - MCV, Hgb, Electrophoresis, Other Features - Dr. Tom DeLoughery @Bloodman #Thalassemias #Alpha #Beta #Comparison #Table #Hematology #Electrophoresis #Diagnosis

Hepatitis B Virus Serology and Interpretation HBsAg - Anti-HBs - Anti-HBc - HBeAg - Anti-HBe - Acute hepatitis B - Chronic hepatitis B with active viral replication - Inactive HBV carrier state (low HBV DNA level) or HBeAg-negative chronic hepatitis B with active viral replication (high HBV DNA level) - Chronic hepatitis B with heterotypic anti-HBs (about 10% of cases) - Acute hepatitis B - Recovery from hepatitis B (immunity) - Vaccination (immunity) - False-positive; less commonly, infection in remote past #HepatitisB #HBV #Serology #Interpretation #diagnosis #laboratory #hepatology

Red Blood Cell (RBC) Morphology Atlas • Microcytic - Iron-deficiency anemia, Thalassemia, Sideroblastic anemia, Lead poisoning • Macrocytic - Megaloblastic anemia, Liver diseases, Myelodysplastic syndrome, Increased reticulocyte count • Spherocytes - Hereditary spherocytosis, Hemolytic anemia, Post transfusion • Target cells - Thalassemia, Liver diseases, Sideroblastic anemia, Hemoglobinopathies • Teardrop cells - Severe anemia, Pernicious anemia, Myeloproliferative anemia • Elliptocytes - Hereditary elliptocytosis, Thalassemia, Iron-deficiency anemia • Sickle cells - Sickle cell anemia, Sickle-thalassemia • Stomatocytes - Malignant tumors, Acute alcoholism • Burr cells - Renal diseases, Liver diseases, Bleeding gastric ulcer, Severe burns • Acanthocytes - Alcohol intoxication, Post-splenectomy, Vitamin E deficiency, Congenital abetalipoproteinemia • Hemet cells - G-6-PD deficiency, Pulmonary emboli • Schistocytes - Hemolytic uremic syndrome, Thrombotic idiopathic thrombocytopenia (ITP), Disseminated intravascular coagulopathy (DIC) #RBC #Morphology #Atlas #key #diagnosis #differential #hematology

Thalassemias on Hemoglobin Electrophoresis Beta-Thalassemia: • Major • Intermediate • Trait Alpha Thalassemia: • Trait-1 (α α/ α-) • Trait-2 (α -/ α-) or (α α/ --) • Hemoglobin H (α -/ --) • Hemoglobin Barts(- -/ --) Hemoglobin E: • Heterozygous • Homozygous Dr. Thomas DeLoughery @Bloodman #Thalassemias #Hemoglobin #Electrophoresis #interpretation #diagnosis #hematology