Author Archives: Tony Breu

For her final “intern question”, Hannah chose a question fundamental to the practice of internal medicine but whose answer remained obscure until very recently. Why does a urinary tract infection (UTI) burn? This question, like so many others that emerge during intern year, arose at 3 in the morning while admitting a patient. Other infectionsContinue reading “Episode 28: Why does a UTI “burn”?”

This week’s episode makes use of knowledge and experience Avi has accumulated practicing his day job as a pulmonologist. He – and others! – have observed that patients with asthma may be improving (i.e., bronchospasm and tachypnea are decreasing) and they will develop an anion gap acidosis. More specifically, they develop lactic acidosis. This phenomenonContinue reading “Episode 27: Why can albuterol cause a lactic acidosis when given in high doses?”

In this episode, we discussed why calcium is used to “stabilize the cardiac membrane” in hyperkalemia. We covered the evidence for this practice and the proposed mechanisms involved. As with many topics, a bit of history can be helpful. Way back in 1883, Sidney Ringer was developing intravenous fluids, including the one that bears hisContinue reading “Episode 26: Why do we give calcium in hyperkalemia?”

For this episode, Avi reached back to a memory of a teaching conference given by a co-resident during internal medicine residency: furosemide works by non-diuretic mechanisms in the acute setting, providing immediate relief to patients with acute pulmonary edema even before an increase in urine output. Furosemide was introduced as a loop diuretic in 1964Continue reading “Episode 25: Why can furosemide improve pulmonary edema from heart failure almost immediately?”

This episode is our second related to the topic of fever. In episode 21 we discussed the connection between fever and rigors and whether either can predict bacteremia. For this episode, we discussed the role and benefits of fever in infectious diseases. To do so required us to go back a few hundred million years.Continue reading “Episode 24: Why is fever beneficial?”