Harrison's PodClass: Internal Medicine Cases and Board Prep

Delve into the fascinating world of shock in medicine. Explore how cellular oxygen supply and demand can lead to organ dysfunction. Discover various types of shock through real ICU cases, including obstructive shock from pulmonary embolism and hypovolemic shock due to massive GI bleeding. Uncover the intricacies of cardiogenic shock arising from myocardial infarction and distributive shock stemming from sepsis. This engaging discussion provides essential insights into diagnosing and managing critical patient scenarios.

Delve into the challenges faced by a 34-year-old woman on a cruise who forgets her medications. Discover the potential complications of glucocorticoid-induced adrenal insufficiency and the critical role of hydrocortisone in her treatment. Learn about the various causes of adrenal insufficiency and how steroid use can suppress the HPA axis. The hosts explore the implications of inhaled steroids and potential drug interactions. Get insights on managing withdrawal symptoms and the importance of patient education on tapering. It's a fascinating look at medication adherence and its real-world impact!

Delve into the intriguing world of cardiac arrest with a case of a 38-year-old experiencing pulseless electrical activity after intubation. Explore the arterial blood gas results that reveal respiratory acidosis and the critical decision-making involved in ventilation. Discover how auto-PEEP creates challenges in obstructive diseases, affecting venous return and leading to PEA. Gain insights on strategies that reversed the patient's condition and manage permissive hypercapnia for improved outcomes.

A fascinating case of a 65-year-old man experiencing shortness of breath during tennis reveals the complexities of pulmonary function tests. The hosts dissect lab results, chest imaging, and echocardiogram findings, leading into a detailed discussion on interpreting spirometry. They explore obstructive defects like COPD, restrictive lung conditions, and the clinical implications of DLCO measurements. Ultimately, emphysema emerges as the diagnosis, illustrating the critical nuances of gas exchange and lung health.

Dive into the world of heart failure with a compelling case study of a 48-year-old woman battling dyspnea. The discussion explores the intricacies of scleroderma, hypertension, and vital exam findings like elevated JVP and crackles. Insightful lab results reveal renal concerns and echo challenges, leading to a deeper understanding of pulmonary hypertension. The hosts clarify heart failure classifications, including reduced and preserved ejection fractions, with a focus on the implications for patient care. It's a captivating journey through cardiovascular complexities!

In this episode in our “Physiology at the Bedside” series, we discuss the causes and pathophysiology of acidosis.Read more on this topic in Harrison'sHarrison's Principles of Internal Medicine, 22nd Edition

Dive into the intriguing case of a malnourished 19-year-old grappling with lower extremity edema. Explore the Starling mechanism behind her pitting edema, as hosts break down hydrostatic and oncotic pressures. Discover how heart failure contributes to fluid accumulation and why compression stockings can be effective. The discussion also highlights the importance of hypoalbuminemia in her condition. This episode combines clinical teaching with engaging insights on physiology, making complex concepts accessible for all.

Dr. Andrew Josephson, a neurology expert and editor at Harrison’s, joins to discuss multiple sclerosis and its connection to optic neuritis. He breaks down symptoms like visual changes and the significance of afferent pupillary defects. Josephson highlights that MS is more prevalent in women 20-40 and often begins with sensory issues. He outlines diagnostic methods such as MRI and emphasizes the importance of early treatment to prevent disability. Tune in for valuable insights into diagnosing and managing these complex conditions!

Dr. Andrew Josephson, a renowned neurologist and editor at Harrison's, dives into crucial aspects of stroke diagnosis and management. He explains the significance of rapid evaluation and the FAST acronym for identifying stroke symptoms. Josephson highlights the differences between ischemic and hemorrhagic strokes, and discusses the importance of timely intervention with treatments like alteplase (TPA). He also shares insights on endovascular therapy advancements and emphasizes public education on stroke awareness to improve emergency responses and outcomes.

Dive into a riveting discussion about pancreatitis, sparked by a case of a 52-year-old man experiencing abdominal pain. The hosts analyze the critical role of risk factors like alcohol and gallstones, complemented by intriguing lab and CT findings. A spotlight on IgG4-related autoimmune pancreatitis reveals its diagnostic challenges and treatment strategies, including glucocorticoids and emerging therapies. Uncover vital insights into how this condition mimics tumors and the importance of awareness for effective diagnosis.