Author Archives: Tony Breu

How does Wenckebach happen? Wenckebach is a fascinating cardiac rhythm. It is a form of heart block with progressive, beat-to-beat prolongation of the PR interval. Eventually, after this progressive PR prolongation, one of the P waves fails to conduct. After this non-conducted P wave, the cycle repeats with a return to the original PR intervalContinue reading “Episode 52 – Way Back Wenckebach”

Why do we replete potassium to >4.0? One of the most common orders placed by inpatient doctors is supplemental potassium chloride in the setting of hypokalemia. Although most don’t learn it in the preclinical years, once a student has spent more than a few hours on the wards they realize nearly everyone repletes the serumContinue reading “Episode 51 – Replete with Kare”

Why can cefepime cause neurotoxicity? Cefepime neurotoxicity is an under-recognized clinical entity and the potential for its presence can confound the assessment of encephalopathic patients. But at the same time, it’s a very effective broad-spectrum antibiotic (i.e., it treats both gram-positive and gram-negative organisms) that clinicians should not fear to use. As background, cefepime isContinue reading “Episode 50 – Antibiotics on the brain”

Why does OSA cause nocturia? On this episode of the podcast, we discussed why and how obstructive sleep apnea (OSA) can cause nocturnal urination. And it’s a common association with one study of 138 patients with OSA reported that 48% experienced nocturia. To begin, OSA is a sleep disorder characterized by episodes of partial orContinue reading “Episode 49 – Curious Incidents in the Nighttime”

Why do we use urinary antigen tests for respiratory pathogens? For many pulmonary infections, we look at the urine to make a diagnosis. This is true for bacterial causes like strep pneumonia and legionella, and also for some fungal infections like Histoplasma. To some extent, this may make sense. Many of us learn early inContinue reading “Episode 48 – Urine the Lung”