Author Archives: Giancarlo Buonomo

Why does iron deficiency cause thrombocytosis? The differential for thrombocytopenia, or low platelets, is a classic. Are all the cell lines down? Usually bone marrow suppression due to anything from leukemia to Lyme disease. Is there new, severe thrombocytopenia and anemia? Make sure to rule out a microangiopathic hemolytic anemia (MAHA). Is there portal hypertensionContinue reading “Episode 129: Ironing Out More Platelets”

Why don’t interstitial lung disease patients typically get increased pCO₂? Early on in medical training, you learn to separate a patient’s oxygen from their carbon dioxide. A COPD patient can be heard wheezing from across the ward with a pCO₂ of 80mmHg and actually have a stable O₂ saturation, while their neighbor with interstitial lungContinue reading “Episode 124- One of the Fastest Reactions in the Human Body”

Why does cirrhosis cause high SAAG ascites? Other than when there’s Thai food at noon conference, it’s the best part of the day on inpatient medicine. A patient comes in with ascites, they get a diagnostic paracentesis, you look at the fluid albumin and subtract it from that serum albumin that you pray you rememberedContinue reading “Episode 119 – While My Liver Gently Weeps”

Why does valproic acid cause elevated ammonia? Ah, serum ammonia. A lab that is often sent and often a head-scratcher. Sometimes an altered patient with cirrhosis and the most textbook asterixis will have a normal serum ammonia. And other times a patient has a sky-high ammonia and you have no idea why. Have you everContinue reading “Episode 116 – Ammonia Rising”

What’s with the black mold growing inside Chernobyl? In a recent Curious Clinicians episode about the tragedy of Chernobyl and the public-health effort to distribute iodine pills to the victims, we mentioned that the reactor that exploded (and even some of the wider fallout area) is now host to a curious organism: A black fungusContinue reading “Episode 114 – The Mold that Eats Radiation for Breakfast”