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 is secondary dengue infection more likely to cause hemorrhagic fever than primary infection? Not all infections confer immunity, but why would prior exposure lead to WORS...
1/4 Why does amphotericin B lead to rigors and fever? I learned about his side effect by the moniker "shake and bake" (thank you First Aid). Let's have a brief look at this commo...
1/14 Why do we feel cold (i.e., experience "chills") when we have a fever? Shouldn't we feel hot? And what are rigors? Answers to these questions will help us better understand...
While reading about ferritin, I came across a fascinating article that asks: 💥Is anemia of chronic inflammation a harmful disorder or an adaptive, beneficial response?💥 The auth...
1/13 Why is ferritin elevated in anemia of chronic inflammation? If the evolutionary point was/is to keep iron away from bacteria, why is our main maker of iron stores elevated? h...
1/ Why is our thirst immediately quenched after the ingestion of water? As we'll note, it takes ~10 minutes for serum osmolarity to change. And yet thirst drops far more rapidly....
1/16 Why do patients with primary polydipsia continue to drink, sometimes to the point of severe hyponatremia? To answer this question, we'll have to explore what makes us thirsty...
1/16 Why does uremia cause platelet dysfunction (i.e., what are "uremic platelets")? The association between kidney disease and bleeding has been observed for centuries and remai...
1/15 [How] does caffeine act as a diuretic? I've long assumed that my morning cup of coffee directly results in my morning trip to the bathroom. But, is it just the ingestion of...
1/15 Why do patients with liver injury or dysfunction have conjugated hyperbilirubinemia? If hepatocytes conjugate, why doesn't this "liver function" decrease in settings of sever...
1/16 Why is azithromycin considered anti-inflammatory? Many of us have prescribed it as part of our acute COPD regimen, not just for its antimicrobial properties, but also for its...
1/14 How do diuretics lead to metabolic alkalosis? I often invoke "contraction alkalosis", typically as a hand-wave explanation as patients' bicarbonate increases with diuresis....