You know the best April Fool’s joke? It’s where you pull the prank on April 10 instead of April 1, because then no one’s expecting it.
Thank you to all the fans, supporters and listeners of How To Win Friends & Influenza. The podcast has been what it is because of you. May your medications be therapeutially potent and your auscultations highly accurate.
Keep on doctoring, only in the most ethical of ways!
About the guest speaker
Mewtwo is a Professor of Kitten and feline specialist working in Sydney, Australia.
Mewtwo enjoys eating, sleeping, chasing string, scratching people and generally being rather annoying.
Piano solos by Mewtwo the cat.
Athletes lose extra salt because they sweat profusely, more than a normal citizen. In such cases, they need a higher sodium intake than the usual recommendations.
Sometimes salt can be serviceable, not just delicious!
- Valentine, V. 2007, ‘The Importance of Salt in the Athlete’s Diet’, Current Sports Medicine Reports, vol. 6, issue 4, pp. 237-240, https://journals.lww.com/acsm-csmr/fulltext/2007/08000/the_importance_of_salt_in_the_athlete_s_diet.9.aspx.
In an experiment involving the ever-unfortunate mice, the following steps occurred:
- Mice inoculated with influenza virus
- Th17 cells activated and migrate to respiratory and gastrointestinal systems
- Both respiratory and gastrointestinal tracts have mucosa, so they are similar in a way
- Th17 cells produce cytokines IL-17A and IFN-γ
- These cytokines mess with intestinal bacteria
- Results in less Lacto-, more Entero-
- Intestinal injury
- Racaniello, V. (2014). How influenza virus infection might lead to gastrointestinal symptoms. [online] virology blog. Available at: http://www.virology.ws/2014/12/10/how-influenza-virus-infection-might-lead-to-gastrointestinal-symptoms/ [Accessed 5 Feb. 2020].
Some people light up joints and some people light up when they hear about joints. Although these are theoretically not mutually exclusive, rheumatologists tend to form the latter group.
In this episode, Dr Allan talks about rheumatology, interesting diseases in the specialty and what it’s like to win an award shaped like a foot.
About the guest speaker
Dr Allan Sturgess is an Associate Professor of Rheumatology and specialist working in Sydney, Australia. He is the Department Head at St George Hospital.
Dr Allan enjoys hiking, reading and generally being rather awesome.
Opening and closing blips by Lily Chen.
The U wave is a smaller structure after the T wave that resembles a second T wave, kind of like Baby Mario, M&M’s Minis or Pichu. It’s best seen in V2 and V3.
Prominent U waves are most commonly found in:
Inverted U waves are abnormal and point to cardiac disease.
- Burns, E. (2019). U Wave. [online] Life in the Fast Lane. Available at: https://litfl.com/u-wave-ecg-library/ [Accessed 29 Jan. 2020].
It’s normal for blood pressure to drop when breathing in.
When you breathe in, the negative intrathoracic pressure increases. That basically means the extra force of all the air you’re leeching from the atmosphere pushes on the insides of the body, squishing the important bits of the cardiovascular system. So, the blood flow gushing out to the rest of the body is reduced a bit, referring to the cardiac output emitting from the left side of the heart. Note that venous return to the right side of the heart increases with inspiration.
A drop in SBP<10 is normal during inspiration. When it’s greater than this, it’s pulsus paradoxus. That can happen in things like:
- inflammatory reaction to parainfluenza virus
- results in airway obstruction, mainly in children because they have smaller airways
- airway obstruction means even bigger negative intrathoracic pressures
- this increases left ventricular afterload, which is the force the heart has to push blood against
- cardiac tamponade
- heart is compressed
- leads to reduced cardiac output
- Van Dam MN, Fitzgerald BM. Pulsus Paradoxus. [Updated 2019 Jun 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482292/
Do the following things, in this order of priority.
- Dehydration – rehydrate with IV fluids
- Insulin – to combat hyperglycaemia
- Electrolytes – potassium shifts are a concern
A simple acronym solves everything. The point is not to let the patient DIE.