Medical Gaslighting Is Very Real (sort of) Strong Medicine 2022-10-04 | A discussion of medical gaslighting: What it is, what patients can do to prevent or to respond to it, and what many people get very wrong about it.0:12 My qualifications to discuss this topic1:40 5 signs of medical gaslighting 11:13 Why I say that medical gaslighting is "sort of" very real14:40 How patients can prevent gaslighting from happening17:02 How patients should respond to gaslighting once it's happenedComments are most definitely welcome. However, any comment that calls out a specific healthcare professional by name will be removed, as will comments with profane or otherwise over-the-top inflammatory language.
Low Urine Output (Rapid Response Calls) Strong Medicine 2023-02-18 | A discussion of how to respond to acutely low urine output in a hospitalized patient, including etiologies, evaluation, and empiric treatment.#InternCrashCourse #MedEd
Median Arcuate Ligament Syndrome (MALS) Strong Medicine 2023-02-05 | A description of the clinical manifestations, pathogenesis, diagnosis, and treatment of the median arcuate ligament syndrome.MALS is also known as celiac artery compression syndrome, celiac axis syndrome, and Dunbar syndrome.Illustrations of MALS courtesy of Dr. Matt Skalski, Radiopaedia.org, rID: 36837CT images of MALS courtesy of Dr. Sami Elhinnawi, Radiopaedia.org, rID: 55455
SVC Syndrome (Oncologic Emergencies) Strong Medicine 2023-01-25 | An overview of the clinical presentation, etiologies, diagnosis, and treatment of the superior vena cava syndrome - a serious complication of non-small cell and small cell lung cancers, among other conditions.CT images of SVC compression and thrombosis both courtesy of Dr Hani Makky Al Salam, Radiopaedia.org, rID: 13267Chest X-ray of SVC stent courtesy of Dr Henry Knipe, Radiopaedia.org, rID: 31410#oncology
The biggest lesson this physician learned from COVID Strong Medicine 2023-01-22 | A physician discusses what the COVID pandemic taught him about science communication and bias.#COVID #coronavirus
Acute Chest Pain (Rapid Response Calls) Strong Medicine 2023-01-19 | An overview of responding to acute chest pain in the hospital, including etiologies, evaluation, and common pitfalls.#MedEd #FOAMed #InternCrashCourse
Acute Somnolence (Rapid Response Calls) Strong Medicine 2023-01-17 | An overview of the etiologies, evaluation, and common pitfalls regarding acute somnolence that occurs in already-hospitalized patients.#MedEd #FOAMed #InternCrashCourse
Acute Respiratory Distress (Rapid Response Calls) Strong Medicine 2023-01-15 | How to approach and treat acute respiratory distress in the hospital.#MedEd #FOAMed #InternCrashCourse
Rapid Response Calls (Intern Crash Course) Strong Medicine 2023-01-10 | An introduction to responding to urgent pages and rapid response calls.#MedEd
What Will Medicine Be Like In 2123? Strong Medicine 2023-01-02 | A doctor makes 10 predictions about the state of medicine in 100 years by extrapolating from recent trends. This is mostly for fun and not meant to be taken too seriously!@0:00 Introduction@1:31 Artificial Intelligence@5:33 Diabetes@7:02 Cancer@7:56 Partitioning of medical specialties@9:58 Longevity@11:58 Nutrition@13:44 Wearables@15:54 Emerging infectious diseases@17:10 Medical education@20:34 Universal health care (in the US)
Neutropenic Fever (Oncologic Emergencies) Strong Medicine 2022-10-30 | The definition, clinical presentation, pathogenesis, treatment, and prognosis of neutropenic fever.Thumbnail incorporated an image of a neutrophil: Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436. Downloaded from Wikimedia Commons October 2022.#oncology #hematology
An Approach to Generalized Pruritus (Itching) Strong Medicine 2022-10-26 | A discussion of the causes and work-up of general pruritus.#clinicalreasoning
How Doctors Drop The Ball On Patient Privacy Strong Medicine 2022-10-19 | One doctor's thoughts on protecting patient privacy on social media, including appropriate use of images, videos, and patient's stories. I do not claim that these thoughts represent the one and only correct way to approach this issue, and I appreciate that there is a spectrum of beliefs on this, as well as a fairly sizable grey zone.Nice tweetorial on protecting patient privacy on Twitter: twitter.com/aoglasser/status/1236053604080873473#HIPAA
Tumor Lysis Syndrome (Oncologic Emergencies) Strong Medicine 2022-10-11 | The manifestations, risk factors, pathogenesis, and prevention/treatment of tumor lysis syndrome - an oncologic emergency that most often complicates acute leukemia and non-Hodgkin lymphoma.#oncology #hematology
IgG4 Related Disease Strong Medicine 2022-09-21 | The clinical manifestations, diagnosis, differential, and treatment or IgG4-related disease.Structure of IgG on thumbnail adapted from IgG.png by user Ikacskovics, made available under CC BY-SA 2.5, downloaded from Wikimedia Commons September 2022.#rheumatology
Adult Onset Stills Disease Strong Medicine 2022-09-18 | A discussion of the clinical manifestations, diagnosis, complications, treatment, and prognosis or adult-onset Still's disease.Adult-onset Still's disease is a a rare, idiopathic, autoinflammatory disorder characterized by the classic triad of recurrent daily fevers, arthralgia/arthritis, and rash, as well as common features of lymphadenopathy, pharyngitis, liver abnormalities, splenomegaly, myalgias, and serositis.#rheumatology
BRASH Syndrome (Bradycardia, renal failure, AV block, shock, hyperkalemia) Strong Medicine 2022-09-11 | An overview of the clinical presentation, pathogenesis, differential diagnosis, treatment, and prognosis of BRASH Syndrome.#FOAMed #medicalschool
Advanced EKGs - Distinguishing VT from SVT with aberrancy Strong Medicine 2022-08-30 | A discussion of how to distinguish VT from SVT with aberrancy among wide complex tachycardias, including the Brugada algorithm and brand new Basel algorithm.#EKG #ECG #electrocardiogram
MedTwitter can be toxic - but it doesnt need to be! Strong Medicine 2022-08-16 | The how and why of #MedTwitter toxicity, and suggestions on how individual users can make it better.Summary of recommendations to reduce MedTwitter toxicity: - Criticize ideas and behaviors, not people - Don't punch down (i.e. faculty to trainees, high-follower accounts to low-follower accounts) - Avoid pile-ons - Don't celebrate being blocked by someone else - Actively seek out other (non-toxic) users to follow with whom you may disagree - Never attribute to malice that which can be explained by ignorance - Consider using DMs to respond to "bad takes" rather than turning every disagreement into a public spectacle - Be liberal with retweeting and amplifying accounts or ideas that have been underappreciated, or which provide an important perspective not widely discussed - When posting original tweets, choose your wording very carefully. If your tweet can be misconstrued, someone will misconstrue it! - When you see someone has been the victim of harsh brigading, Twitter humiliation, or attempts at cancellation, reach out to them with a kind DM. Even if you disagree with whatever post of theirs initially triggered the brigade. Actually, especially if you disagree with it.
Advanced EKGs - Ventricular Tachycardia (Classification & Localization) Strong Medicine 2022-08-07 | How to classify VT based on duration, morphology, and mechanism. Also how to localize scar-based VT, as well as identify specific forms of idiopathic VT.Related videos:Beginner video on how to identify tachyarrhythmias: youtu.be/pd5FF8jGR78More on PVCs: youtu.be/gQDCgKb-7fQSudden Cardiac Death (e.g. HOCM, ARVD, Brugada): youtu.be/Lm1HAmCnr9ALong QT Syndrome: youtu.be/UTek1i23yuQ#FOAMed #cardiology #ECG
Advanced EKGs - PACs and PVCs (i.e. premature beats) Strong Medicine 2022-07-27 | How to identify and describe premature atrial and ventricular contractions.#EKG #ECG #electrocardiogram
An Approach to Chronic Abdominal Pain Strong Medicine 2022-06-20 | A discussion of the causes and evaluation of chronic abdominal pain (i.e. constant or recurrent pain lasting at least 2 months)Companion video on acute abdominal pain: youtu.be/_PDOXlVGeuYAdditional videos on a few select causes of chronic abdominal pain...Endometriosis: youtu.be/QELcUuOaQkIGastroparesis: youtu.be/gjD6ZPPkG5wAnterior cutaneous nerve entrapment syndrome: youtu.be/o2ZPgP0HWSM#ClinicalReasoning #MedEd #medicalschool
The Arterial System and Blood Pressure Strong Medicine 2022-06-06 | A overview of the physical factors that determine blood pressure, including the Windkessel effect, arterial compliance, and the effect of age. Respiratory pulse pressure variation is also discussed.0:00 Introduction1:10 Mean arterial pressure3:06 The Windkessel effect10:14 Determinants of SBP, DBP, and pulse pressure16:51 Pulse pressure variation22:29 SummaryHypertension Playlist: youtube.com/playlist?list=PLYojB5NEEakUE7iQbOInL95nq0FmualD7For a deeper dive on using electric circuits to model the Windkessel effect of the cardiovascular system: link.springer.com/article/10.1007/s11517-008-0359-2Image of house adapted from home_creative_tail.svg, downloaded from Wikimedia Commons May 2022, provided by creative tail under CC BY SA 4.0.#cardiology #physiology #medicalschool
How to Perform a Preoperative Evaluation Strong Medicine 2022-05-23 | A discussion of how to medically assess patients who may be undergoing surgery, including predicting risk of adverse outcomes. The Revised Cardiac Risk Index, MICA score, and the ACS Surgical Risk Calculator are included.#residency #internship #internalmedicine
Monkeypox: Should you be worried? Strong Medicine 2022-05-19 | An overview of monkeypox. What is it? What symptoms does it cause? How is it treated? And why it's ok to not be worried about it (yet).#InfectiousDiseases
Viscosity and Turbulence Strong Medicine 2022-04-27 | The determinants of blood viscosity, turbulence in blood vessels, and the mechanisms of heart murmurs and bruits.0:00 Introduction0:39 Viscosity3:55 Laminar vs. turbulent flow8:00 Summary#physiology #CVphysiology #cardiology
Hemodynamics Strong Medicine 2022-04-21 | An overview of hemodynamics from a physiology perspective (i.e. the application of fluid dynamics to the cardiovascular system).0:00 Introduction1:42 Hydrostatic pressure and the JVP8:31 Flow and the Continuity Equation12:37 Resistance and Poiseuille's Law21:23 "The Most Important Equation in Cardiovascular Physiology"26:17 Summary#cardiology #CVphysiology #physiology
An Approach to Dysphagia Strong Medicine 2022-04-10 | A discussion of the etiologies and evaluation of dysphagia (e.g. difficulty swallowing).
The Ehlers-Danlos Syndromes (EDS) Strong Medicine 2022-03-17 | An overview of the Ehlers-Danlos syndromes, including discussion on the classification, clinical presentation, diagnostic criteria, treatment, and prognosis.Website of the Ehler-Danlos Society: ehlers-danlos.com/what-is-edsChannel of Izzy Kornblau, a prolific YouTuber with EDS (great information from a patient's perspective): youtube.com/c/IzzyKornblau/videosThe 2017 International Classification of the Ehlers-Danlos syndromes (includes full diagnostic criteria): onlinelibrary.wiley.com/doi/full/10.1002/ajmg.c.31552The existence of an association between EDS, dysautonomia (esp. POTS), and mast cell activation syndrome has been recently proposed. Its existence is controversial. Unfortunately, most of the relevant scientific literature is behind a paywell, but here are a few papers which are not:Paper on the possible connection between dysautonomia and EDS: onlinelibrary.wiley.com/doi/10.1002/ajmg.c.31951Paper on the possible connection between mast cell disorders and EDS: onlinelibrary.wiley.com/doi/10.1002/ajmg.c.31555And a page from the Ehlers-Danlos society on mast cell disorders and how they might be associated with EDS: ehlers-danlos.com/2017-eds-classification-non-experts/mast-cell-disorders-ehlers-danlos-syndrome-2#EDS #Ehlers-Danlos
An Approach to Altered Mental Status (e.g. delirium) Strong Medicine 2022-03-09 | An overview of the causes and evaluation of states of acutely altered mental status, including delirium, somnolence, agitation, and psychosis.0:00 Introduction3:50 Subtypes of AMS (delirium, somnolence, agitation/psychosis)10:20 Diagnostic framework (i.e. the etiologies/causes)20:43 Evaluation of AMS29:47 Summary#clinicalreasoning
Clinical Vignettes on Hemostasis (Less Common Scenarios) - Hemostasis: Lesson 14 Strong Medicine 2022-03-02 | The final video in this series on hemostasis in which I discuss some clinical vignettes with accompanying multiple choice questions on uncommon scenarios (to contrast it with the common scenarios from lesson 13).#hematology #FOAMed
An Approach to Chronic Nausea and Vomiting Strong Medicine 2022-02-24 | A discussion of the etiologies and work-up of chronic nausea and vomiting, including etiologies of recurrent/episodic N/V.#gastroenterology #clinicalreasoning #FOAMed
Clinical Vignettes on Hemostasis (Common Scenarios) - Hemostasis: Lesson 13 Strong Medicine 2022-02-21 | A discussion of 5 clinical vignettes with board-style multiple choice questions on the topic of hemostasis (i.e. pathology of platelets and the coagulation cascade).#hematology #MedEd
An Approach to Acute Nausea and Vomiting Strong Medicine 2022-02-17 | An overview of the etiologies and evaluation of an adult patient presenting with nausea and vomiting for 1 week or less. Included is a brief overview of the physiology of the vomiting reflex.#ClinicalReasoning #MedicalSchool #Nausea
An Approach to Erectile Dysfunction Strong Medicine 2022-02-06 | A discussion of the causes and work-up of erectile dysfunction, including an overview of the physiology of erections. Sorry comments are turned off. Scam artists were continuous bombarding them with ads for dangerous "natural" ED treatments.#ED #ErectileDysfunction #ClinicalReasoning
Strong Medicine 500k subscriber AMA (Ask Me Anything) Strong Medicine 2022-02-02 | AMA for hitting the 500k subscriber milestone. Thanks for the support everyone!The Stanford School of Medicine Class of 2020 Parody Music Video: youtube.com/watch?v=_uaTqoA4QY8&list=PLYojB5NEEakUcRQCdbMz24Qf7nxK_s0eF&index=1Clinical Problem Solvers website (for improving diagnostic reasoning): clinicalproblemsolving.comVideo on COVID and Burnout: youtu.be/WV0gPHClW5sVideo on “Behind the Scenes” of Strong Medicine: youtu.be/ZUOcuBVqQWgApologies, when talking about recommended textbooks for improving clinical reasoning, I forgot to mention Andre Mansoor’s Frameworks for Internal Medicine. Like Symptom to Diagnosis, it’s organized around specific symptoms, abnormalities, and presentations, rather than focusing on clinical reasoning as an independent skill.@0:38 Intro@1:23 What is your daily schedule like?@2:53 How to estimate pretest probability?@4:23 Do you remember everything that you teach here?@4:42 Favorite band?@5:15 Opinion on Pfizer booster dose? Why was the booster video taken down?@5:42 Recommendations for books on learning differential diagnosis?@7:50 Is it possible to learn concepts and decisions trees by heart? Opinion on mnemonics.@10:06 What are the ten most important papers in recent years? (I only discuss one)@11:04 Why and when did you decide to become a general medicine physician (hospitalist)?@12:41 Additional recommendations for textbooks @15:27 Advice for a student interested in cardiology. Is it normal to hate textbooks, and instead rely on Qbanks?@16:41 Discussion about how I don’t know much about the process of international trainees coming to the US to practice@18:06 Is it a problem when the ER hands off patients to the inpatient teams without much work-up or thinking?@20:35 How do I keep my knowledge updated?@22:26 How much have I incorporated POCUS into my practice?@23:19 When did I become confident in my clinical judgment?@25:53 How do you continue learning medicine if practicing in an outpatient setting if your training was predominantly inpatient?@26:55 Thoughts on implementing a med ed (or health) course for high school students.@27:59 What do you look forward to in the future of medicine?@28:20 Advice to an “underperformer” when it comes to applying to medical school.@30:51 What is the most exciting aspect of practicing medicine these days? What are you tired of and can’t stand?@31:44 Do physician use Apple Watch data?@32:22 Requests for specific upcoming video topics@33:31 Do you have a teaching position, or do you only do this YouTube channel?@33:58 At what age should medical professionals retire?@36:37 With the internet, have patients become more informed or just more paranoid?@37:44 What does it take to be an extraordinary physician? Who is your role model?@40:20 How do you personally handle compassion fatigue and burnout?@42:02 What tools do you use to make and edit your videos?@43:05 Recommendations about getting more subspecialty expertise in cardiology from family medicine@44:31 Do you have students and juniors on your tail during rounds?@45:15 Have you considerably changed your opinion on an aspect of medicine in recent years? And, what is your approach to a patient whose symptoms don’t point towards any particular disease?
Anterior Cutaneous Nerve Entrapment Syndrome Strong Medicine 2022-01-26 | An overview of the pathogenesis, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of the anterior cutaneous nerve entrapment syndrome (ACNES) - an important, often overlooked cause of chronic abdominal pain.#abdominalpain #ACNES
AMA Announcement Strong Medicine 2022-01-19 | To celebrate reaching the 500k subscriber milestone, it's time for another AMA (ask me anything) - however, with the huge caveat that you don't ask me for individualized medical advice about personal health problems.
Is Anti-Vaxxer an Offensive Slur? Strong Medicine 2022-01-16 | Some viewers got upset that I've been using the term "anti-vaxxer". So who exactly do I consider to be an "anti-vaxxer"?What is the Future For Vaccines (And Trust) by Medlife Crisis: youtube.com/watch?v=5iABaxRWGxk#COVID #antivax #vaccines
An Approach to Male Infertility Strong Medicine 2022-01-09 | A discussion of the causes and evaluation of male infertility. 0:00 Introduction2:39 Overview of normal reproductive physiology and anatomy6:36 Causes of male infertility13:14 Evaluation of a patient with infertility19:15 Summary#infertility #clinicalreasoning #FOAMed
An Approach to Female Infertility Strong Medicine 2022-01-04 | A discussion of the causes and evaluation of female infertility. The accompanying video on an approach to male infertility will be posted Jan 9.A quick point of clarification on terminology: In this video, I predominantly use the word, female, and on a few occasions, woman, to refer to an individual with a uterus and ovaries who desires to become pregnant. I acknowledge that not all such individuals identify as a woman, and I mean no disrespect towards those who are transgender or gender non-conforming. For a discussion of the terminology regarding sex and gender, please consider checking out my video on The Diversity of Sex, Gender, and Sexual Orientation here: youtube.com/watch?v=2yM_P6WdRJU0:00 Introduction4:29 Overview of normal reproductive physiology and anatomy11:44 Causes of female infertility18:39 Evaluation of a patient with infertility25:36 Summary#infertility #clinicalreasoning #FOAMed
COVID, Burnout, and the Loss of Empathy Strong Medicine 2021-11-28 | A discussion of how pandemic-related moral injury of healthcare workers has led to a loss of empathy, and how that's manifested.#COVID #empathy #moralinjury
The Cardiac Cycle and PV Loops Strong Medicine 2021-11-09 | A discussion of some of the nuances of the cardiac cycle, pressure-volume (PV) loops including changes observed in different pathological states, and myocardial work/oxygen consumption.0:00 Introduction0:41 Nuances of the cardiac cycle5:48 PV loops16:10 Myocardial work and O2 consumption20:15 Summary#cardiovascular #physiology #heart
Cardiac Excitation-Contraction Coupling Strong Medicine 2021-11-03 | A description of the relationship between the excitation of a cardiac muscle cell via an action potential, and that cell's contraction via actin-myosin cross-bridge cycling.Contents:0:00 Introduction and Learning Objectives0:41 Excitation3:10 Contraction6:24 The coupling 9:31 SummaryVideo incorporated image of T-tubule: 1023_T-tubule.jpg by OpenStax Anatomy and Physiology, provided under CC BY 4.0, downloaded from Wikimedia Commons Oct 2021.#cardiovascular #physiology #medicalschool
10 Unwritten Rules of Internship Strong Medicine 2021-09-29 | Not everything you need to know to succeed as a medical intern will be written down somewhere.(Yes, I know this would have been better to post in July than in September...)#internship #interncrashcourse
Serotonin Syndrome Strong Medicine 2021-09-26 | A review of the clinical presentation, etiologies, differential diagnosis, and treatment of serotonin syndrome.A part of Strong Medicine's series on Underappreciated Diseases.#MedEd #Toxicology #SSRI
Diabetic Ketoacidosis (DKA) Strong Medicine 2021-09-14 | An overview of the presentation, etiologies, and management of diabetic ketoacidosis. Included is a comparison with the hyperosmolar hyperglycemic state (HHS) and a brief discussion of the biochemistry of ketone bodies.Thumbnail incorporated image of insulin from Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014". WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436.#insulin #diabetes #dka
Responding to Sexual Harassment in Medicine Strong Medicine 2021-08-18 | A doctor and medical school professor discusses sexual misconduct in academic medicine, with an emphasis on practical advice for victims and bystanders.RAINN (sexual assault resource): rainn.orgArticle from Bloomberg on sexual misconduct in medicine: bloomberg.com/news/features/2019-04-30/america-s-medical-profession-has-a-sexual-harassment-problemSexual Harassment in Medical Schools: The Challenge of Covert Retaliation as a Barrier to Reporting: journals.lww.com/academicmedicine/fulltext/2018/12000/sexual_harassment_in_medical_schools__the.17.aspxThumbnail adopted from image provided by Mohamed Hassan via Pixabay#sexualharassment #sexual assault
Organ Systems Are Dumb Strong Medicine 2021-08-11 | A brief discussion on why conventional organ systems should be updated to reflect modern understanding of physiology and pathology.Medlife Crisis' Organ Tier List: youtube.com/watch?v=mtfwmRlQAmQ#Physiology #Medicine #Anatomy
