Tony Breu
Hospitalist, VA Boston. Assistant Professor, @harvardmed and @HMSbioethics. Co-host, @CuriousClinPod. Usually at #AMreport. Views are my own.
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1/14 🤔Why does it take weeks for the radiographic evidence of pneumonia to clear? Patients often feel better DAYS after starting treatment. And yet the chest x-ray takes WEEKS to...
1/4 - The Mystery A doctor is on overnight call in the hospital. They are also hooked up to continuous ECG monitoring. 🤔What might cause the following tracing? https://t.co/O3PrI...
1/16 🤔Why does subarachnoid hemorrhage lead to deep/inverted "cerebral T-waves"? This ECG finding is so dramatic. But as we will see, these patients often have normal hearts. Why...
1/12 🤔Why does iron deficiency cause fatigue, even in the absence of anemia? I have often equated iron with hemoglobin and oxygen-carrying capacity. But there is so much more to...
1/6 - The Mystery A patient presents with a serum B12 level above assay. And yet, the clinician strongly suspects the patient has B12 deficiency. 🤔How might this occur?
1/17 🤔Why do we use epinephrine to treat cardiac arrest? Epinephrine can CAUSE cardiac arrest. And yet we give it as part of ACLS to treat the condition it caused. This paradox r...
1/6 In acute myocardial infarction (AMI), serum potassium levels are often low. And patients with AMI are at risk for ventricular tachycardia and fibrillation. Does hypokalemia c...
1/13 🤔 Why do patients with acute myocardial infarction often present with diaphoresis (sweating)? And, is there any significance when this symptom is present? 🎟️Let's have a loo...
1/3 It's well known that primary cancers have a predilection for particular metastatic sites. For example: Prostate ➛ Bone But, amazingly, some cancers appear to have an affinity...
1/15 🤔Why are splenic metastases so rare? I always saw the spleen as a lymphoid organ similar to lymph nodes. If the latter are major sites of metastases, why not the former? Why...
1/16 Why do corticosteroids increase the BUN/Cr ratio? I see this often after starting patients on prednisone. But why? And, does it also happen with excess endogenous steroids...
1/16 Why do we use 100,000 CFU/mL as our cut-off for true bacteriuria? This question was posed to me by @BryanCiccarelli. The answer has an interesting history so I thought I'd sh...