Harrison's PodClass: Internal Medicine Cases and Board Prep

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.

Dive into a compelling case of a 23-year-old experiencing chronic abdominal pain and diarrhea. The hosts analyze the nuances of her symptoms, discuss the complexities of diagnosing IBS, and outline the critical features to consider. Explore various management options, from dietary interventions like the low-FODMAP diet to medications such as loperamide and eluxadoline. The conversation also highlights red flags to rule out other conditions and the importance of individualized treatment approaches.

This discussion centers around a 64-year-old man experiencing fatigue, insomnia, and palpitations. The hosts delve into the diagnosis of new atrial fibrillation, backed by an ECG confirmation. They highlight the serious risks associated with AF, including increased mortality and stroke risk. Acute management strategies are explored, advocating for rate control with beta blockers, along with the importance of anticoagulation prior to cardioversion. Essential anticoagulation guidelines and long-term considerations are also introduced.

Dive into the intriguing case of a 63-year-old with elevated hemoglobin tied to fever and diarrhea. Discover how travel history and heavy tobacco use play into the diagnosis. Learn about the difference between primary and secondary polycythemia, including the pivotal role of EPO levels and the implications of JAK2 mutations. The importance of identifying hyperviscosity symptoms and when to administer phlebotomy is discussed, wrapping up with key takeaways on effective management strategies.

Explore the fascinating dynamics of thyroid function during pregnancy with a real-life case involving a 25-year-old patient. Discover how TRH, TSH, and T4/T3 interact, along with factors that can alter thyroid tests. Learn why universal screening isn't recommended and who should undergo targeted TSH testing. The discussion also highlights the increased need for thyroid replacement during pregnancy, paving the way for crucial clinical insights.

Explore the fascinating world of venomous snakes and the clinical challenges of snake bites. Discover the symptoms of neurotoxic venom and the crucial steps involved in pre-hospital care. The hosts discuss a real case of a 39-year-old bitten while traveling in India, emphasizing the urgency of antivenom treatment and debunking outdated first-aid methods. Engage with a quiz on snake identification and learn about the global impact of snake bites as a neglected tropical disease. This episode blends medical insight with practical knowledge!

A fascinating case of a 73-year-old woman grappling with fever and altered mental status unveils the complexities of sepsis. The discussion pivots around foodborne illness, particularly disseminated listeria, and how it can escalate dangerously, especially in the elderly. Insightful treatment strategies and the vital role of patient history in identifying listeria transmission are explored. The high stakes of appropriate antibiotic interventions underscore the urgency of responsive healthcare.

Listeners dive into the intriguing case of a pregnant woman with abnormal urinalysis, highlighting the complexities of urinary tract infections. The discussion covers the prevalence and gender differences in UTIs, focusing on the unique challenges faced by pregnant patients. Importance is placed on managing asymptomatic bacteriuria to prevent serious complications. The necessity of prompt treatment and urine dipstick tests is emphasized, making the podcast a must-listen for anyone interested in women's health issues.