Why does an autoimmune antibody stimulate the thyroid in Graves’ disease? When we think of antibodies, such as monoclonal antibodies that target specific diseases, we often think of them as blocking receptor-ligand interactions or binding to pathogens to neutralize them. Yet in Graves’ disease, we actually find the opposite of what we would normally expect:Continue reading “Episode 123 – Why-roid”
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Episode 122 – When CRP goes missing
Why do patients with active lupus have a low CRP? Although the erythrocyte sedimentation rate (ESR) is typically high in active lupus, C-reactive protein (CRP) is often normal. What’s particularly cool about this finding is that it lends insights into the mechanism of lupus and potentially its cause. The earliest report alluding to this discordanceContinue reading “Episode 122 – When CRP goes missing”
Episode 121 – The Forgotten Factor
Why doesn’t factor 12 deficiency cause bleeding? In July 1953, freight brakeman John Hageman’s doctors faced a scenario that might feel familiar to anyone who has ever done preoperative medicine consults. Hageman had planned to undergo a partial gastrectomy for peptic ulcer disease, but his preoperative tests showed a prolonged clotting time. In the 1950s,Continue reading “Episode 121 – The Forgotten Factor”
Episode 120 – No Sleep for the Weary
Why can’t people with familial fatal insomnia fall asleep? Have you ever wondered why you feel so awful when you don’t get enough sleep? Well, that’s because it is no exaggeration when we say we need sleep to survive, so much so that we spend approximately ⅓ of our lives sleeping. Insomnia can certainly feelContinue reading “Episode 120 – No Sleep for the Weary”
Episode 119 – While My Liver Gently Weeps
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”
The Curious Clinicians 