Pinned
1/ Collated thread for new GI fellows
⭐️GI Fellow Resources ⭐️
▪️Websites
▪️Guidelines
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▪️Podcasts
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▪️Board study
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📲 bit.ly/3KwqCVG (hyperlinked 📄)
#GITwitter
Carl Kay, MD
2,243 posts
Carl Kay, MD
@CarlKayMD
Army GI @CRDAMC | Asst Prof of Med @USUhealthsci Husband | Girl Dad x2 | Interests: 26.2, QI, & #MedEd via @SAUSHEC_GI @IUMedSchool & @WheatonCollege
- Zones & Patterns of Liver Injury Zone 1 (ALT > AST) ▪️Autoimmune hepatitis ▪️Viral hepatitis Zone 3 (AST > ALT + ⬆️ LDH) ▪️Ischemia ▪️Toxic events ▪️Heart failure ▪️Budd-Chiari syndrome Note: ALP is predominant in basolateral membrane #LiverTwitter 👊
- All 4️⃣ GI Society Guidelines in 1️⃣ Place @AGA_Gastro 48 guidelines @AmCollegeGastro 55 guidelines @ASGEendoscopy 83 guidelines @AASLDtweets 23 guidelines Google folder: 🔗 drive.google.com/drive/folders/… Save this link & quickly download all PDFs Updated as 🆕 guidelines published!
- Types of Colectomy ▪️Low anterior resection ▪️High anterior resection ▪️Sigmoid colectomy ▪️Left hemicolectomy ▪️Right hemicolectomy ▪️Abdomino-perineal resection ▪️Total proctocolectomy ▪️Subtotal colectomy ▪️Total abdominal colectomy 🔗 bmj.com/content/366/bm… #GITwitter
- Magic Numbers in Hepatology ▪️MAP goal >82 in outpts ▪️Plt <160 = concern ▪️Spleen ≥12 cm ➡️ portal HTN ▪️Portal v ≥13 mm ➡️ portal HTN ▪️SAAG ×10 ≈ HVPG (1.1=11) ▪️TIPS safe for ascites if MELD-Na ≤18 ▪️MELD-Na >15 ➡️ refer for transplant ▪️“6-month sobriety rule” = outdated
- Hemochromatosis vs Hemosiderosis Hemochromatosis ▪️Iron accumulation + organ damage ▪️Iron in hepatocytes ▪️Lack of stainable iron in Kupffer cells ▪️HIC >71 umol/g or HII > 1.9 Hemosiderosis ▪️Iron accumulation without toxicity ▪️Iron in Kupffer cells #LiverTwitter 👊
- Parasite Diseases of Liver & Biliary Tract ▪️Amebiasis ▪️Malaria ▪️Babesiosis ▪️Leishmaniasis ▪️Toxoplasmosis ▪️Toxocariasis ▪️Hepatic capillariasis ▪️Ascariasis ▪️Strongyloidiasis ▪️Trichinosis ▪️Schistosomiasis ▪️Fascioliasis ▪️Clonorchiasis ▪️Echinococcosis #LiverTwitter 👊
- 1/ Approach to Ascites Thread ▪️3-step approach (PMN, SAAG, protein) ▪️Lab evaluation ▪️Differential by fluid color ▪️Correction for bloody fluid ▪️Ascites DDx square (SAAG x Protein) ▪️Bacterial peritonitis profiles ▪️Runyon’s criteria for secondary infection #LiverTwitter 👊
- Indications for IV & Oral contrast in Abdominopelvic CT IV Contrast ▪️Suspected tumor ▪️Infection/Inflammation ▪️Vascular eval ▪️Trauma ▪️Postop complications Oral Contrast ▪️Bowel obstruction ▪️Perforation ▪️Fistula assessment ▪️Mass localization 🔗 acr.org/-/media/ACR/Fi…
- “Prophylactic” Cholecystectomy Indications ▪️children + gallstones ▪️morbidly obese prior to bariatric ✂️ ▪️gallstones >3cm ▪️porcelain gallbladder ▪️gallbladder polyps >1 cm ▪️gallbladder polyps >6mm + RF for 🦀 ▪️gallstones + sickle cell ▪️gallstones + dysmotility #GITwitter
- GI Toolkit for Gastroparesis (more than prokinetics) ▪️Ondansetron 8 mg TID ▪️Granisetron patch 34 mg weekly ▪️Prochlorperazine 5-10 mg QID ▪️Chlorpromazine 10-25 mg QID ▪️Scopolamine patch q3d ▪️Aprepitant 80 mg QD ▪️Meclizine 12.5-25 mg TID ▪️Dronabinol 5-10 mg TID #ACG2025
- 🚨 New ACG Crohn’s Guidelines (2025) ▪️Scope at 6–12 mo post-op ▪️Early advanced therapy = key ▪️Anti-TNF, IL-23, JAKi > mesalamine ▪️High-risk = smoking, prior surgery, penetrating dz ▪️Surgery for abscess >2cm or strictures 🔗 bit.ly/acg-crohns-2025
- Differentiate ascites 1️⃣Diuretic-intolerant ➡️ hyponatremia, hypotension 2️⃣Diuretic-refractory ➡️ max spironolactone + furosemide = no natriuresis Urine Na/K check 🧪 ▪️Na > K + ↓ wt → sensitive ▪️Na < K + ↑/↔ wt → resistant ▪️Na > K + ↑/↔ wt → sensitive, poor diet
