Clinician. Author of #FrameworksForInternalMedicine. Cofounder pdxpdx.com. piped.video/c/AndréMansoor
Portland, OR
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A middle-aged man presents with sudden-onset dyspnea and hypotension.
His neck veins hold the key to the diagnosis.
Can we determine the cause using only the history and physical exam?
A bedside medicine mystery. 🧵
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ACUTE PULMONARY EMBOLISM.
The abrupt increase in pulmonary vascular resistance causes acute RV pressure overload, reduced forward flow, and hypotension.
Notice how the history and physical exam guided us to the diagnosis.
That's the power of a framework.
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Don't memorize endless differentials.
Understand the physiology. Build a framework. Let the history and physical exam guide you.
This is the approach taught in Frameworks for Internal Medicine.
📚 amazon.com/dp/1975193121
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André Martin Mansoor retweeted
without a diagnosis. I followed the framework, and the high ferritin level led me to the diagnosis. My consultant knew not much about this condition so he sent me to discuss it with HOD Rheumatology. He took history, applied Yamaguchi criteria and said *Impressive* .
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📚 Congratulations to our randomly selected Frameworks giveaway winners !
🇺🇸 @IanTally — signed print copy
🇵🇰 @khan_skeptic — ebook
Please DM me to arrange delivery !
Thank you to everyone who entered. I loved reading how you’re using - or hoping to use - the book !
📚 Frameworks giveaway !
🇺🇸 Signed 2nd-edition print copy
🌍 Ebook for an international winner
To enter, reply with your country + how the book has helped you, or why you’d like a copy. Reposts appreciated!
2 random winners. One entry/person. Free entry.
Closes Oct 22, 9am PT
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André Martin Mansoor retweeted
📚 Frameworks giveaway !
🇺🇸 Signed 2nd-edition print copy
🌍 Ebook for an international winner
To enter, reply with your country + how the book has helped you, or why you’d like a copy. Reposts appreciated!
2 random winners. One entry/person. Free entry.
Closes Oct 22, 9am PT
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What does ankle clonus actually look like?
Here’s a 10-second bedside demonstration. The full video shows how to test for it and what the finding means:
piped.video/AXEezuC70M0
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