Tony Breu
Hospitalist, VA Boston. Assistant Professor, @harvardmed and @HMSbioethics. Co-host, @CuriousClinPod. Usually at #AMreport. Views are my own.
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1/11 🤔Why does chronic hepatitis C infection "require" the intermediary of cirrhosis in order to cause hepatocellular carcinoma (HCC)? Chronic hepatitis B can "skip" this step, go...
1/12 - Mystery #1 You are seeing a patient recently diagnosed with heart failure and started on GDMT. You notice that their hemoglobin (HGB) has increased (12 → 13 g/dL) in the i...
1/18 🤔Why does Clostridioides difficile infection (CDI) so rarely cause bacteremia? Patients with CDI are some of the sickest I've cared for. And yet, the causative bacterium is r...
1/7 🤔What is the hemodynamic response to a chronic hemoglobin of 1.5 g/dL. A fascinating 1963 study published in @CircAHA provides some interesting answers. Let's have a look at P...
1/17 🤔Why don't we transfuse to a normal hemoglobin? In many cases, we aim to restore values to the normal range. Potassium and other electrolytes. Even white blood cells. But no...
1/13 🤔Why does iron administration relieve symptoms of restless leg syndrome (RLS) in some patients? Turns out BRAIN iron deficiency matters more. Let's have a look.
I argue against sodium restriction in acute heart failure. The line of reasoning is that: (1) Current evidence suggests restriction is not helpful. (2) And may be harmful. (3) The...
1/18 🤔Why is the BUN/Cr elevated in upper gastrointestinal bleeding? This question has been covered by @AdamRodmanMD and @WilliamAird4 but the literature is SO FASCINATING that I...
1/12 🤔Why is plasma albumin low in nephrotic syndrome? "Urinary losses!" seems like the obvious answer. But there is much more to it. Let's have a look.
1/15 🤔Why do antibiotics reduce the risk of rebleeding after acute variceal hemorrhage? I understand why antibiotics reduce infections, but the mechanism by which they reduce rebl...
1/18 🤔Why does heart failure with preserved ejection fraction (HFpEF) lead to sodium retention? With reduced ejection fraction (HFrEF), decreased cardiac output (CO) leads to neur...
1/5 - The Mystery The serum LDH in TTP is more than twice that seen in autoimmune hemolytic anemia (AIHA) 🤔If the source of LDH in both conditions is lysed RBCs, shouldn't the va...