Patrick Desamours, PA-C, MBA, SFHM, @padesamours Twitter profile

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

11 months

@EM_RESUS I see vegetation or possible thrombus. DDx: 1. Endocarditis 2. Atrial Fibrillation 3. Cardiomyopathy 4. Thromboembolic Disease 5. Structural Heart Abnormalities Plan: STAT TEE

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

8 months

@IhabFathiSulima Classic symptoms of Bell’s palsy. Here are some viruses that have been linked to Bell's palsy: 1. Epstein-Barr 2. adenovirus 3. rubella 4. influenza B 5. coxsackievirus 6. Herpes simplex

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

@drkeithsiau Gout. Likely was given NSAIDS now presents with melena due to upper GI bleed.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

@drkeithsiau Fish tank granuloma? It is a rare skin infection caused by Mycobacterium marinum. I have never seen it clinically.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

@drkeithsiau Osteonecrosis of the Jaw? Is the patient on bisphosphonates or denosumab? There have been reported cases with patients who have been treated with these medications.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

@drkeithsiau First thing came to my mind: Kawasaki disease. Please tell me I am right 🤣🤣

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

11 months

@BrownJHM Infectious mononucleosis, commonly caused by the Epstein-Barr virus (EBV) considering the clinical presentation.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

@EM_RESUS DDx: 1. Metastatic ovarian cancer involving the lungs. 2. Metastatic breast cancer involving the lungs. Any history of breast or ovarian cancer? I am curious of further study results (CT scans, PET scans, biopsies, and laboratory tests etc…). Looking forward to tomorrow.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

@drkeithsiau You schooled me on this previously professor, I don’t want to cheat so I’ll pass today. 🤣🤣 On a serious note - Thank you for the amazing contents and teaching points. Much appreciated.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

11 months

@drkeithsiau Erythema migrans due to Lyme disease. DDX: Lyme disease Southern tick-associated rash illness (STARI) Cellulitis Allergic reaction or contact dermatitis.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

10 months

@drkeithsiau Rovsing's sign - It is positive when there's pain in the right lower abdomen upon palpating the left side, suggesting acute appendicitis.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

11 months

@OGdukeneurosurg Human Bites Tx: Augmentin If allergic to penicillin: Clindamycin. Trimethoprim/sulfamethoxazole. Ciprofloxacin (Cipro)

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

11 months

@drkeithsiau meningococcal septicemia?

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

11 months

@OGdukeneurosurg Dx: rupture of the long head of the biceps tendon Tx: 1. Conservative measures such as rest and physical therapy to manage symptoms. 2. Surgical repair to reattach the tendon to its original insertion point on the glenoid.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

10 months

@BBankheadMD You finally got the right nanny. She is a keeper. Don’t ever let me know who that nanny is, I will move across country for her.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

11 months

@drkeithsiau Thrombotic thrombocytopenic purpura (TTP) - a rare blood disorder in which thrombi (blood clots) form in small blood vessels throughout your body. There are two main types of thrombotic thrombocytopenic purpura: inherited and acquired. Common symptoms include: •Bleeding into

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

@drkeithsiau Hepatitis? Is Acute hepatitis panel available?

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

@drkeithsiau Endocrine Neoplasia Type 1 (MEN1) - a rare tumor in multiple endocrine glands, including the pituitary, parathyroid, and pancreas. (I have never seen it clinically) These tumors usually lead to hormonal imbalances and overproduction of certain hormones.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

@drkeithsiau GI bleed 2/2 donepezil?

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

@EM_RESUS @elonmusk needs to this. What an inspiring story! Thank for sharing it, @EM_RESUS !

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

@drkeithsiau I see cobblestone. Dx: Crohn's disease

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

@drkeithsiau hepatopulmonary syndrome (HPS? - any history of alcohol use?

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

11 months

@NicoGagelmann Superior vena cava (SVC) due to obstruction of the superior vena cava likely from diffuse large B cell lymphoma which led to the facial swelling and unconsciousness.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

11 months

@drkeithsiau Gastrointestinal stromal tumor (GIST)? A gastrointestinal stromal tumor (GIST) is a type of tumor that originates in the gastrointestinal tract. GISTs are often caused by mutations in specific genes. What was the biopsy result? What were the presenting symptoms?

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

2 Haitians. 🇭🇹 2 hospitalists. 2 healthcare leaders. One goal: Excellent patient care, save lives, and take care of our team. #mymedicaldirector #HowWeHospitalist @SocietyHospMed @JHospMedicine

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

10 months

@drkeithsiau Placenta: The Tree of Life - One of the human body's most vital organs. In the early stages of life, every person depended on the placenta for survival.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

8 months

@drkeithsiau Kehr’s Sign - Associated with splenic rupture. A ruptured spleen is a medical emergency. It can cause life-threatening internal bleeding.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

11 months

#MedX ⤵️⤵️

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

@drkeithsiau @AGA_Gastro Behçet's disease? - Though rare, multiple ulcers in the mouth and colon with the associated symptoms are indicative. DDx: 1. Other Inflammatory Bowel Disease (IBD) 2. Infectious Colitis

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

11 months

@drkeithsiau You must keep your 🩸🩸patients dryer than this 😅 Here’s how: 👇🏽👇🏽

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

@babbymd Knowing when to give up is a skill. 🤣🤣

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

@alexiawalts @drkeithsiau Yes, it can be considered contagious. However, the risk of transmission from human to human is low. It is primarily transmitted from fish to humans through direct contact with contaminated water.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

9 months

@drkeithsiau Hold discharge for uninsured, undocumented, homeless patient in need of 6 weeks of IV antibiotics…

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

@drkeithsiau @NEJM So many diagnoses in mind… let’s just keep it simple - Negligence.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

@drkeithsiau The most common Cryptosporidium. Other possible agents: E. Coli Giardia Norovirus

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

11 months

@nihardesai7 @BrownJHM @MorphologyAmigo @Torsadepointles @DoctorBhavsar @ManualOMedicine @NicoGagelmann @Dishaar88241487 @adiv2711 @chandrachud_n Tuberculosis (TB)

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

10 months

@drkeithsiau Alcohol flush reaction or Asian flush - it is common in people of East Asian descent. It is related to how the body metabolizes alcohol. It is metabolized primarily in the liver by enzymes such as alcohol dehydrogenase (ADH). One of the byproducts of this process is

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

@TheBlondeRN Patient: “I don’t want my medication right now, come back later.”

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

11 months

@BrownJHM Swimmer's Itch aka cercarial dermatitis - it is caused by an allergic reaction to microscopic parasites that are released by certain species of waterfowl and snails.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

11 months

@brhooooom911 @stats_feed Carvana Co. is a holding company. The Company operates as an e-commerce platform for buying and selling used cars. Through the Company's platform, consumers can research and identify a vehicle, inspect it using its patented 360-degree vehicle imaging technology, obtain financing

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

11 months

@OttersParlance @EM_RESUS The ESC guidelines recommend performing a TTE as soon as infective endocarditis is suspected. After a cardiology consultation for a TEE, they will provide their recommendation. Of course, patient would be managed appropriately. Patient care is always a top priority.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

11 months

@dermatology Disseminated intravascular coagulation (DIC) associated with purpura fulminans - a rare and serious condition characterized by clotting within small blood vessels throughout the body, leading to skin lesions, organ dysfunction, and a significant risk of mortality.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

@DrZedZha Just wrote a threat about lack of compassion. Here are 5 steps to improve compassionate leadership skills. 1. Take care of yourself 2. Listen to learn from your patients 3. Prioritize patient-centered care 4. Cultivate self-awareness 5. Show empathy

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

@drkeithsiau …then he replies, “please consult cardiology for surgical clearance”

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

@NicoGagelmann Small bowel obstruction due to ingested foreign body.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

11 months

@drkeithsiau DDx: 1. Peripheral Neuropathy - likely due to nutritional deficiencies, alcohol use, and metabolic imbalances in setting of cirrhosis. 2. Terlipressin-Induced Ischemic - (Terlipressin is used in the treatment of cirrhotic patients with variceal bleeding.)

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

11 months

@drkeithsiau Necrolytic migratory erythema (NME) - associated with glucagonoma, a rare tumor of the pancreas.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

11 months

@drkeithsiau Hemochromatosis - It is a genetic disorder that causes the body to absorb too much iron. This leads to a buildup of iron in various organs and tissues, which can result in these symptoms. It can affect the many organs including heart, liver, pancreas, skin, joints, others.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

8 months

@IhabFathiSulima pseudofolliculitis barbae - it is a skin irritation issue.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

9 months

@drkeithsiau Gastric varices? Can cause fatal internal bleeding if they burst.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

@r_pa_s Yes!!!

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

11 months

@drkeithsiau Bell's palsy due to Lyme disease

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

@EM_RESUS Clinical depression is real. It can happen to anyone.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

@JenNeuman10 I am sorry about your loss 💔 My deepest condolences 🫶🏾

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

11 months

@drkeithsiau Splenic hematoma/injury likely due to trauma. This can occur in sickle cell patients as well.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

11 months

@med_712 Meningococcal septicemia - considering clinical status of very hill with high-grade fever and a rash all over.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

8 months

@drkeithsiau Bifid uvula It doesn't necessarily mean there's something wrong. Some people are just born with a naturally split uvula.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

11 months

@drkeithsiau Cardiology said continue. Nephrology said discontinue 🤔🤔🤔😅😅

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

11 months

@drkeithsiau Addison's disease - A rare chronic condition in which your adrenal glands don’t produce enough of the hormones cortisol and aldosterone.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

@drkeithsiau intestinal endometriosis?

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

@drkeithsiau Diabetic dermopathy? How old is the patient? As Diabetes-related dermopathy is more common in diabetic patients over 50 years of age.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

@NeilFlochMD Start his patient on a regular diet.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

10 months

@drkeithsiau Small bowel obstruction - I see a “coiled-spring” appearance?

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

@Drkhenaizan @drkeithsiau 🤣🤣🤣 say it. We are a supportive group. We don’t judge.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

11 months

@DGlaucomflecken It’s important to have a safe space to vent. 😎

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

@DGlaucomflecken Something must be done about this. The stress of caring for patients is too much for ER docs. They should not be taken advantage of by private equity companies.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

11 months

@imedverse @drkeithsiau Polycystic kidney disease (PKD) - a genetic disorder that causes cysts to grow in the kidneys. There are two types of polycystic kidney disease: 1. Autosomal dominant polycystic kidney disease (ADPKD). 2. Autosomal recessive polycystic kidney disease (ARPKD). How common is

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

8 months

@Dr_Oubre It’s confusing. I personally do not use abbreviations when writing notes. I want to be as clear as possible. Make it easy for anyone who is reading my notes to understand my thought process. Clear communication is kindness. We can use a little more kindness in medicine.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

11 months

@drkeithsiau Murphy's sign - used to assess for acute cholecystitis. DDx: Pleuritic chest pain (pain that worsens when taking a deep breath)- It often indicates inflammation of the pleura.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

11 months

@BrownJHM Wilson Disease - A rare genetic condition where copper builds up in your body. It affects your liver, brain, eyes and other organs.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

@drkeithsiau esophageal cancer? This would be my first DDx for a patient with discolored nails, weight loss and difficulty swallowing. What did endoscopy show?

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

10 months

@drkeithsiau External jugular vein. Patient has CHF?

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

10 months

@imedverse @dermatology Kaposi sarcoma - A form of soft tissue sarcoma. It affects people with immune deficiencies, such as HIV or AIDS.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

8 months

@IhabFathiSulima Hydrocephalus - excessive accumulation of cerebrospinal fluid (CSF) within cavities of the brain. There are four main types: 1. Communicating hydrocephalus 2. Non-communicating hydrocephalus 3. Normal Pressure Hydrocephalus (NPH) 4. Hydrocephalus ex-vacuo

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

11 months

@drkeithsiau First thing came to mind is psychological reasons? DDx: 1.Dermatographia 2.Allergic Reaction Disorders 4.Occupational or Environmental Factors

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

11 months

@drkeithsiau Mononucleosis (mono) aka “the kissing disease” - Commonly caused by the Epstein-Barr virus (EBV). How common is (mono)? The Epstein-Barr virus (EBV) that causes mono is extremely common. Who might get mononucleosis (mono)? There are often two peaks when people acquire EBV:

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

@PostOpPrincess Many nurses want to make a change in their career, but they feel like they have no choice. Financial insecurity is a major concern for them, as they can't afford to leave their current job. This is unacceptable. Our nurses work tirelessly to provide the best care possible, and

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

8 months

@drkeithsiau I would have done the same thing. We have cared for patients at the lowest point of their lives. Why not a lift? So kind of you. 🖤

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

@thedankoe "There is a time for everything, and a season for every activity under the heavens." - Ecclesiastes 3:1

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

8 months

@EM_RESUS So sad. We see this too often in medicine. If something is abnormally growing, get it checked. You might save your life.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

12 years

I will release my college transcript for a mere $100,000.00....Does anyone want to see my grades?

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

@elonmusk @elonmusk when should we expect Starlink to be available in Haiti. Could be a game changer for a desperate nation.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

@radRounds Abnormal: NG tube in the wrong location - the left lung.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

11 months

@dermatology Dx: Herpes simplex There are two types of herpes. HSV-1 tends to affect your mouth and face. HSV-2 tends to affect your genital area. Once a person contracts herpes, it's a lifelong condition. Tx: Acyclovir (Sitavig, Zovirax) Famciclovir (Famvir) Valacyclovir (Valtrex)

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

@DeidreShannon9 @alexiawalts @drkeithsiau It is advisable to report cases to your local healthcare authorities or healthcare provider in order to assist public health officials in gathering important data. You should confirm the reporting process with your local health department, as it may vary between regions.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

8 months

@IhabFathiSulima Achalasia - a rare disorder in which damaged nerves in the esophagus prevent it from working as it should. Tx options: nonsurgical options (balloon dilation, medications, and botulinum toxin injection) and surgical options. The goal of treatment is to relieve symptoms by

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

9 months

@drkeithsiau Abdominal aortic aneurysm? The most common complication is an aneurysm rupture, which causes 150,000 to 200,000 deaths each year around the world. AAA rupture leads to potentially fatal internal bleeding. Your risk goes up the larger an aneurysm grows.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

10 months

@IhabFathiSulima @DrShadyYousif1 Seborrheic dermatitis- a common skin condition that causes redness, scaly patches, and dandruff. Some studies have suggested a potential association between seborrheic dermatitis and an increased risk of developing Parkinson's disease later in life.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

9 months

@drkeithsiau Pernicious anemia - An autoimmune condition that prevents your body from absorbing vitamin B12. Tx: B12 replacement.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

@JeromeAdamsMD When I left home for college, my mom realized I might never come back by paying attention to what I packed. She couldn't stop crying. Sadly, she was right. 🤣 Home will always be home… keep the doors open. ❤️

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

11 months

@bobbisworldrn When you find the answer, please let me know. 🤯 Also, please find out why they refuse to leave after receiving all treatment. 🏥🩺😅

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

9 months

@ScientistsLift The p-value is nonsense. We need to stop using it. It has no statistical significance.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

10 months

@drkeithsiau Medicine is so interesting… we must alway have an open mind. I learn something today, thank you! 🙌🏾🙌🏾

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

11 months

@drkeithsiau Absolutely. Adequate hydration with an isotonic sodium chloride solution is the single most effective measure for reversing hypercalcemia and protecting the kidneys. This may be combined with furosemide to enhance calcium excretion if there is evidence of hypervolemia.

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

@drkeithsiau DDx: 1. Alcohol flush reaction (a genetic condition where the body has difficulty metabolizing alcohol, leading to facial redness, particularly on the cheeks and nose.) 2. Rosacea

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

Happy Doctors' Day to all the amazing physicians out there who work tirelessly to keep our communities healthy! Your commitment to healing, care, and compassion never goes unnoticed. @freckledpedidoc @ASK_HM17 @subhaairan @AndreaHadleyMD @Dallas_Holladay @jenreadlynn

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

11 months

@nihardesai7 @NEJM @BrownJHM @Torsadepointles @DoctorBhavsar @adiv2711 @Dishaar88241487 @KirtanPatolia @PanktiMehta24 Any history of tobacco and alcohol use, medications, lifestyle. DDX: 1. Poor oral hygiene 2. Tobacco use 3. Medication induced 4. Excessive alcohol consumption

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

8 months

@drkeithsiau The struggle is real. 😅 Then you are thinking: “what if I fail?, what would people think of me? My parents will disown me” 😫 I think medical students should enjoy the ride. You got this! 💪🏽

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

1 year

I am deeply honored and grateful to join The Hospitalist's editorial advisory board. It's truly a privilege to serve an organization that has created such an outstanding community of healthcare professionals.

Amteshwar Singh, MD MEd FACP (he/him/his)

@amteshwar

1 year

@SocietyHospMed @padesamours @doctorkevinMD #Hospitalist #HowWeHospitalist

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Patrick Desamours, PA-C, MBA, SFHM,

@padesamours

9 months

@IhabFathiSulima Paracentesis - usually done when a person has ascites (too much fluid builds up in the abdomen). This condition often happens in people who have cirrhosis of the liver.

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