اسأل الله في هذا الشهر الكريم انه يفرج همك ويرزقك من حيث لاتحتسب ياارب والله يادكتور بسطت اشياء دكتوري معقدها ومخليها مملة. مصر مفروض تكون فخوووورة فيك 😔❤️❤️❤️❤️❤️❤️🇪🇬🇸🇦
It is the first video of this channel that I've watched and God do I love these! I am taking the oath to watch most of its content if not all. God, so smart!
Me, too. I hope I found this channel when I was in nursing school. My stupid textbook did not explain anything. My professors read PPT (don't get me wrong. they are nice, but they read PPT.) Everything was needed to be remembered. My brain was getting burned. I kept asking why. Nobody had a freaking answer.
Medicosis, I just had a patient this weekend. She came in at the end of Oct, with acute severe abdominal pain and was diagnosed with superior mesenteric artery thrombosis. She has abd surgery right after. They could not find the blood clot. However, there was no s/s of necrosis of her bowel. When I saw her this weekend, she was lying in bed with heparin drip at the rate of 1600U/hr, NPO and with PPN and lipids running. Her platelet level was within normal range. Her PTT was 67(WNL). However, since the day before yesterday, her urine became dark black tea color and there was brown sediment in her foley tubing. And her surgical site started seeping minimal amount of bright red blood. There was no more s/s of active bleeding. She was hemodynamically stable. However, her WBC spiked up to 60. We reported the hematuria to the doctor and also the WBC. She was already on multiple antibiotics. And we could not stop the heparin, because her bowel would die. But I was really concerned about the hematuria. It was very difficult. Can you imagine she had 4 IVs running?
I dont know why i found you channel JUST NOW. can’t believe it, my academic life would be so much easier if i found it earlier. Anyways, thank you so much!!!! This was very helpful
Thank you! I had HIT type 2 years back and my doctors did a poor job explaining its effects and cause. Thankful to finally have a better understanding of what happened to me.
Warfarin can be given for HIT according to my textbook that's a copy Warfarin (goal INR 2-3) for all patients with confirmed HIT diagnosis once the platelet count is above 150,000/mm3 a.Duration depends on the presence of thrombus. i.No detected thrombus - 30 days ii.Thrombus - Continue for appropriate duration depending on thrombus type (typically 3-6 months). b.Start with doses of 5 mg/day or less, and overlap with injectable anticoagulant for at least 5 days. c.Will need to account for elevation in INR caused by both argatroban and bivalirudin during transition
What are the signs and symptoms of HIT? Pain, redness, and swelling of an arm or leg. Bruise-like discoloration of your skin. A rash or sore where a heparin shot was given. Weakness, numbness, or problems moving your arms or legs.
Thank you soo much for your videos!! Have MRCP in 1 month, your videos are soo helpful! You make studying fun! Laughing in humour white studying at 11 pm in my bedroom, something I had never imagined!
Sir your tutorial is excellent and I couldn't stop laughing at your sense of humour too, made the tutorial more interesting, stay blessed and hope to see more 🙏 😊 ❤
As a lab tech who works with a Sysmex XN CBC instrument on a regular basis, I can confirm that it is, in fact, a stupid-butt machine.😆 Thanks for these videos! They're helping me a lot while I'm studying for my hematology final this week.
Dear Medicosis Thank you so much for your lectures. It has helped me a lot with my study. I can only wish that no medical student would live in restricted-resources areas (like middle eastern countries) to not afford your brilliant lectures. Best regards.
Hi Medicosis, can you talk a little bit more about HIT type I. In you video, you said type I is clinically insignificant. Does that mean it will not cause severe thrombosis and bleeding symptoms as type II? How do I distinguish type I and type II?
Thank you for your amazing video. A lot for me, and a bit above my head, but I will listen several times. You could have a second career as a stand-up comic. Maybe at a destressinv conference for medical people? ❤️❤️❤️
@MedicosisPerfectionalis, in HIT type II, does the immune system destroy the involved platelets? When you say the platelets level increase after the incident, do you mean the bone marrow produces new platelets?
02:43 You mentioned that LMWH inhibits factor X alone & NOT the rest of the upstream clotting factors of the intrinsic pathway ; that's why the aPTT is NOT prolonged !!!!! As you know ; both intrinsic & extrinsic coagulation pathways converge towards factor X to activate it in order to proceed down the coagulation cascade ! So how comes an inhibited factor X alone does NOT prolong the aPTT ?
Hi Doc... Can I get VITT after get vaccinated by Astrazeneca vaccine... After getting the vaccine, I'm having persistent abdominal pain from last 5 days...
My brother has developed hit type 2. Platelets is down 60 and now 45. Hematoma in glutes (12-17 centimeter). Dr is now giving him platelets and fondaparinux. But not argitroban. What should they be doing? Administer platelets or not? Thanks
I have a blast watching your videos! But why does the doctor sprinkle dust on his head when type II HIT is confirmed? You are a smart funny and confusing man
All i wanted to know was HOW But we are soo stressed on just mugging up that when asked how it happens we tell them well those who can cause coagulation can also cause anti coagulation It would have taken just extra 1-3 min to tell how the fuck is it causing thrombosis BUT NOoooo.
This not clear ???!!! 🤨🤨 What mean ( anything that makes you clot, make bleed) ? This is not clear explanation. Unclear point, please explain it in another way..
![Lp. Сердце Вселенной #60 РОЖДЕНИЕ ЛОЛОЛОШКИ [Финал] • Майнкрафт](http://i.ytimg.com/vi/YoR0pAV9FVQ/mqdefault.jpg)
❤️ 💊 Cardiac Phrmacology: www.medicosisperfectionalis.com/products/cardiac-pharmacology-course/
I never EVER thought I'd say this but... I'm actually having fun watching these videos lol
Wow 🤩
Thank you so much 😊
I am honored!
This is literally the best thing that has happened to me the whole week 😅. Can't believe it's taken me so long to find this channel
Thank you so much ☺️
@@MedicosisPerfectionalis me too. You are AMAZING!!! 🌟🌟🌟🌟🌟
You're the reason for my survival in medical school.❤️
Thank you 😊
Underrated Channel.... Great work.You deserve million subscribes 👍🏻
Thank you so much 😊
اسأل الله في هذا الشهر الكريم انه يفرج همك ويرزقك من حيث لاتحتسب ياارب والله يادكتور بسطت اشياء دكتوري معقدها ومخليها مملة. مصر مفروض تكون فخوووورة فيك 😔❤️❤️❤️❤️❤️❤️🇪🇬🇸🇦
Thank you so much 😊
this helps me understand HIT I and HIT II way better.
Awesome 👏
This author is hilarious, I love his teaching approach!
Thank you 🙏
It is the first video of this channel that I've watched and God do I love these! I am taking the oath to watch most of its content if not all. God, so smart!
Thank you so much 😊
This is amazing! I wish I found this channel years ago.
Very educational and entertaining
Thank you
My pleasure 😇
Me, too. I hope I found this channel when I was in nursing school. My stupid textbook did not explain anything. My professors read PPT (don't get me wrong. they are nice, but they read PPT.) Everything was needed to be remembered. My brain was getting burned. I kept asking why. Nobody had a freaking answer.
I wish i found this channel in 1st year instead of 4th year. Fantastic stuff and love your personality that you inject into the video to make it fun!
Thank you so much,Jacob!
I appreciate you!
Would you please help me by sharing?
Your voice and humor. Thank you Dr.
My pleasure 😇
Thanks!
My pleasure 😇
That well drawn out Messi in the cascade 🙌
☺️😊😊
Medicosis, I just had a patient this weekend. She came in at the end of Oct, with acute severe abdominal pain and was diagnosed with superior mesenteric artery thrombosis. She has abd surgery right after. They could not find the blood clot. However, there was no s/s of necrosis of her bowel. When I saw her this weekend, she was lying in bed with heparin drip at the rate of 1600U/hr, NPO and with PPN and lipids running. Her platelet level was within normal range. Her PTT was 67(WNL). However, since the day before yesterday, her urine became dark black tea color and there was brown sediment in her foley tubing. And her surgical site started seeping minimal amount of bright red blood. There was no more s/s of active bleeding. She was hemodynamically stable. However, her WBC spiked up to 60. We reported the hematuria to the doctor and also the WBC. She was already on multiple antibiotics. And we could not stop the heparin, because her bowel would die. But I was really concerned about the hematuria. It was very difficult. Can you imagine she had 4 IVs running?
Oh my!
No words"..immense hardwork n made insanely easy for us...stay forever
Thank you so much 😊
I dont know why i found you channel JUST NOW.
can’t believe it, my academic life would be so much easier if i found it earlier.
Anyways, thank you so much!!!! This was very helpful
My pleasure 😇
Welcome to the family!
Watching this with Robbins pathology just cleared my whole concept
Thanks bro
Love from india
Thank you 🙏
Thank you! I had HIT type 2 years back and my doctors did a poor job explaining its effects and cause. Thankful to finally have a better understanding of what happened to me.
Thank you 🙏
How is your health today?
@@MedicosisPerfectionalis I am much better, thank you! It took quite some time to fully recover from the PEs, but I am doing well.
Warfarin can be given for HIT according to my textbook that's a copy
Warfarin (goal INR 2-3) for all patients with confirmed HIT diagnosis once the platelet count is above
150,000/mm3
a.Duration depends on the presence of thrombus.
i.No detected thrombus - 30 days
ii.Thrombus - Continue for appropriate duration depending on thrombus type (typically 3-6
months).
b.Start with doses of 5 mg/day or less, and overlap with injectable anticoagulant for at least 5 days.
c.Will need to account for elevation in INR caused by both argatroban and bivalirudin during
transition
Dude you’re awesome greetings from cardiology resident
Thank you 🙏
Ur angel in disguise. Tq doc.
You’re very welcome 😊
What are the signs and symptoms of HIT?
Pain, redness, and swelling of an arm or leg.
Bruise-like discoloration of your skin.
A rash or sore where a heparin shot was given.
Weakness, numbness, or problems moving your arms or legs.
What A superb methodology, Mind blowing felt Immense pleasure 😊 to watch.....May God give me strength to learn it for thousands years 😀🙏🏻😊
Thank you so much!
Thank u for your superb teaching master accept my salute 🙌 le second year mbbs student from India 😅
Thank you!
Thank you soo much for your videos!! Have MRCP in 1 month, your videos are soo helpful! You make studying fun! Laughing in humour white studying at 11 pm in my bedroom, something I had never imagined!
I am honored! Thank you so much for watching my videos!
Would you please help me by sharing my videos with others?
Sir your tutorial is excellent and I couldn't stop laughing at your sense of humour too, made the tutorial more interesting, stay blessed and hope to see more 🙏 😊 ❤
Thank you so much 😊
As a lab tech who works with a Sysmex XN CBC instrument on a regular basis, I can confirm that it is, in fact, a stupid-butt machine.😆
Thanks for these videos! They're helping me a lot while I'm studying for my hematology final this week.
You’re very welcome 😊
Good luck 🍀
As a medical student, I'm living for the undisguised medical student hate ♥ Thanks for the clear lecture doc
My pleasure 😇
I think im not dropping out after all.. thanks dude
My pleasure 😇
A complex theme made very simple and in nice presentation
Thank you so much 😊
Great lecturer
Amazing lecture ☺️
Thank you 🙏
Favorite videos thank you! I have a topic discussion on the topic and your lectures really help make things click! Keep it up!
Thank you 😊
Fantastic work. Thanks!
awesome explanation, and great sense of humor gentle doctor.
those 3 dislikes must be from the aforementioned medical students
Haha 😂
Dear Medicosis
Thank you so much for your lectures. It has helped me a lot with my study. I can only wish that no medical student would live in restricted-resources areas (like middle eastern countries) to not afford your brilliant lectures.
Best regards.
love your videos, you really deserved million follows. just one request if you will slow down when explaining, it will help a lot
Thank you so much 😊
what a great video, loved the commentary but very helpful, information was presented in a great way!
Thank you 😊
Hi Medicosis, can you talk a little bit more about HIT type I. In you video, you said type I is clinically insignificant. Does that mean it will not cause severe thrombosis and bleeding symptoms as type II? How do I distinguish type I and type II?
Just loved it
Thank you 😊
Kermit was right. It's the greet top. Thank you for yet another valuable lesson.
Haha 😂
You’re very welcome 😊
I remember your comment on the last video...You’re so smart!
@@MedicosisPerfectionalis But you are so much smarter than I lol
Nope...You’re smarter!
Wow believe me I had fun watching this💝
Thank you so much 😊
Best tutorial ever 👏👏thank you so much
My pleasure 😇
Thank you for your amazing video. A lot for me, and a bit above my head, but I will listen several times.
You could have a second career as a stand-up comic. Maybe at a destressinv conference for medical people? ❤️❤️❤️
Thank you 😊
I was studying from Harrison and understood nothing and came here . Thankyou 🌟
You explained HIT very well. Thank you very very much!
Thank you 🙏
Just, just superb
Thank you so much 😊
Great video as usual.Life saver!!
Thank you so much ☺️
Lmao. I’m dyin at “your woke professor might care”. Very well made brother. Thank you and God bless you
God bless you too!
Good job👍👍
Thank you 🙏
I’m studying for a critical care exam right now and I can’t stop laughing.
Haha 😂
Laughter is a cheap medicine…Even cheaper than Heparin 😉
great work, keep going!
Thank you 🙏
You are awesome !
Thank you 😊
You're simply amazing!!!! Loved it!!! ❤️❤️
Thank you 🙏
Thank you so much for that explanation, that was really awesome
My pleasure 😇
Thank you so much for watching!
You are Amazing!! 🙌🏻
Thank you 🙏
Are you fucking kidding me? 1 min into the video and i already learned some amazing things
Happy to hear that!
Thank you 😊
😂😂😂😂😂😂😂😂😂 love the comedy that you add to your videos
I am grateful! Thank you!
Wow this is so cool. So funny. "Who named these things?"
Really I also think so...why so difficult to remember drug names
Thank you 😊
Please make us a video about antiphospholipid syndrome dr
OK 👍
@@MedicosisPerfectionalis thank u u r the best
you are hilarious! love your videos, thanks so much for making them!
My pleasure 😇
Cool as usual 🌷
Thank you so much 😊
Amazing
Thank you so much!
My pleasure 😇
@MedicosisPerfectionalis, in HIT type II, does the immune system destroy the involved platelets? When you say the platelets level increase after the incident, do you mean the bone marrow produces new platelets?
02:43 You mentioned that LMWH inhibits factor X alone & NOT the rest of the upstream clotting factors of the intrinsic pathway ; that's why the aPTT is NOT prolonged !!!!!
As you know ; both intrinsic & extrinsic coagulation pathways converge towards factor X to activate it in order to proceed down the coagulation cascade !
So how comes an inhibited factor X alone does NOT prolong the aPTT ?
Argatroban
Lepirudin
IgG
Platelet factor4
I don’t understand
Sir I have written important key words so that when I come again I know the overview
Sir, Instead of using direct thrombin inhibitors, can we use fondaparinux in HIT2 after stopping heparin?
that '' SHUTUP'' was personal hehehe
:)
Thank you so much sir
My pleasure 😇
You are awesome.
Thank you 🙏
Hi Doc...
Can I get VITT after get vaccinated by Astrazeneca vaccine...
After getting the vaccine, I'm having persistent abdominal pain from last 5 days...
Thank youuuu sooo much...
My pleasure 😇
My brother has developed hit type 2. Platelets is down 60 and now 45. Hematoma in glutes (12-17 centimeter). Dr is now giving him platelets and fondaparinux. But not argitroban. What should they be doing? Administer platelets or not? Thanks
Why would we use ELISA and not Coombs test?
Coombs is for RBCs, not the best for platelets!
awesome!
Thank you 🙏
I have a blast watching your videos! But why does the doctor sprinkle dust on his head when type II HIT is confirmed? You are a smart funny and confusing man
I was just joking 🙃
I meant to say: “it’s a tragedy.”
What other anticoagulants could you use other than argatroban?
Have you watched the video?
why does the thrombocytopenia cause clotting? Shouldnt it bleed more?
ah i think you explained it at around the 12 minute mark
Plzz make a video menustrl cycrcls
Ok
@@MedicosisPerfectionalis tunku soooooo much sir
Fity munh!
Me working into my exam hall knowing Hit is Thrombosis 💪🏻
I wish you success!
"shut up, If a student says that in real life I will kick him in the nuts" xD
Just joking 🙃
So funny!! thank you!!
My pleasure 😇
ما تبطل بضان يسطا واشرح زي الناس وبطل تشد في بضاني انا تعبت
بس شرح جامد الله ينور
This vdo🥰♥♥
Thank you 😊
رهيييييب 😂😂😂😂😂😂😂😂😂
Thank you 🙏
WOW!
Thank you 🙏
All i wanted to know was HOW
But we are soo stressed on just mugging up that when asked how it happens we tell them well those who can cause coagulation can also cause anti coagulation
It would have taken just extra 1-3 min to tell how the fuck is it causing thrombosis BUT NOoooo.
As a lab tech I take offense at you calling our machines stupid LOL. Most platelet problems come from preanalytical errors!!
I was joking 🙃
I can only imagine how much stress lab techs have to work under!
I appreciate you 😊
Proves smart people can be funny too
Haha 😂
HIT tpye1 medical student😁😁😁 doctor dancing
Haha 😂
This not clear ???!!! 🤨🤨
What mean ( anything that makes you clot, make bleed) ?
This is not clear explanation. Unclear point, please explain it in another way..
❤️❤️❤️❤️💡💡💡
The platelets go crazy? That’s the explanation?
Yup 🤪
dudeeee i love u ,,,, hahahahhah
Thank you 😊
Horrible presentation but good information.
Ok
You filipino 😮
Vedio starts at 11:28 robbins dude 🤫🤫😂😂
Slow down. You're talking too fast. Someone who doesn't have much knowledge of the subject will find it difficult to follow u.
Thank you for letting me know!