Tony Breu, MD

Hospitalist and Director of Resident Education, VA Boston. Faculty, @HMSbioethics. Mets fan. Usually at #AMreport and thinking about #TWDFNR. Views are my own.

Titles #Tags
What is the mechanism of night sweats? #pathophysiology #tweetorial #nightsweats #fever
Why is the chancre of primary syphilis painless? #pathophysiology #physiology #ID #InfectiousDisease #syphilis #historyofmedicine #historyofmed #bedsiderounds
Why do we use multiple drugs to active treat tuberculosis (TB)? #pathophysiology #physiology #ID #InfectiousDisease #pharmacology #medications #tuberculosis #TB #MTB #drugresistance
Why, if thrombocytopenia leads to petechiae, do we not see the same with aspirin? #pathophysiology #physiology #hematology #hemeOnc #coagulation #bleeding #clotting #asapirin #ASA
Why do thiazide diuretics cause more hypokalemia than loop diuretics? #pathophysiology #physiology #renal #nephrology #thiazides #thiazide #loopdiuretic #furosemide #HCTZ #chlorthalidone #hypoK #hypokalemia #hypertension
How does the drug name Sinemet (carbidopa/levodopa) provide insights into why it was developed and its mechanism of action? #pathophysiology #physiology #pharmacology #pharmacy #medications #neurology #parkinsons #PD #sinemet #carbidopa #levodopa #etymology #dopamine #BBB
Why do we administer potassium to a goal of ≥4.0 mEq/L? #pathophysiology #physiology #cardiology #nephrology #renal #hypokalemia #AMI #acuteMI #myocardialinfarction #potassium #repletion
How does alcohol cause macrocytosis? #pathophysiology #physiology #hematology #macrocytosis #alcohol #EtOH #MCV #acetealdehyde #adducts
Why are right-sided pleural effusions more common in patients with cirrhosis? #pathophysiology #physiology #hepatology #GI #gastroenterology #pulmonary #pulmonology #pleuraleffusions #hydrothorax #hepatichydrothorax #cirrhosis
Why does albumin decrease in inflammatory conditions? #pathophysiology #physiology #nephrology #renal #Rheumatology #albumin #CRP #ESR #acutephasereactant #acutephaseprotein
Why do patients with immune thrombocytopenia (ITP) appear to have less severe bleeding than patients with equivalent platelet counts due to bone marrow suppression? #pathophysiology #physiology #hematology #coagulopathy #ITP #immunethrombocytopenia #bleeding #thrombosis #platelets #platelet #PLT #MPV #IPF
Why do we use urine antigen tests to diagnose respiratory pathogens #pathophysiology #physiology #ID #InfectiousDisease #renal #nephrology #pulmonary #pulmonology #urinaryantigen #urinaryAg #strep #legionella #respiratory #pneumonia
How does acetaminophen decrease fever and pain, without affecting inflammation? #pathophysiology #physiology #MedEd #Medications #Medication #pharmacy #acetaminophen #APAP #NSAIDs #fever #pain #inflammation #analgesia #antipyretic #PGE2 #COX #cyclooxygenase #peroxidase
What causes the increase in pCO₂ in patients with acute COPD exacerbation treated with supplemental oxygen? #pathophysiology #physiolog y#MedEd #pulmonary #Pulmonology #COPD #emphysema #hypercarbia #hypercapnea #oxygen #carbondioxide #O2 #CO2 #haldaneeffect #haldane #bohreffect #bohr #hypoxemia #vasoconstriction
Does the tryptophan in turkey really cause a food coma? #pathophysiology #physiology #MedEd #neurology #sleep #tryptophan #thanksgiving #foodcoma #LNAA #largeneutralaminoacids
How do thiazides (e.g., hydrochlorothiazide/HCTZ) lower blood pressure? #pathophysiology #physiology #MedEd #renal #nephrology #hypertension #diuretics #HCTZ #thiazides #thiazide #chlorthalidone #SVR #CO #cardiacoutput
Why do we need to correct hypomagnesemia in order to correct hypokalemia? #pathophysiology #physiology #MedEd #renal #nephrology #hypokalemia #hypoK #hypomagnesemia #hypoMg #potassium #magnesium #repletion #ROMK
How do steroids cause an increase in the white blood cell (WBC) count (i.e., leukocytosis)? #pathophysiology #physiology #MedEd #hematology #immunology #ID #InfectiousDisease #steroids #corticosteroids #glucocorticoids #leukocytosis #WBC #demargination #neutrophils #neutrophilia
Is there a mechanistic rationale for the use of sanatoria in the treatment of tuberculosis? #pathophysiology #MedEd #historyofmedicine #ID #InfectiousDisease #TB #MTB #tuberculosis #sanitorium #sanitoria #satitarium #BedsideRounds #VitaminD
Why is the AST/ALT ratio >2 in alcoholic liver disease? #pathophysiology #physiology #MedEd #hematology #GI #gastroenterology #ALT #AST #transaminitis #alcoholicliverdisease
Why does cirrhosis predispose to “bacterial translocation”? #pathophysiology #physiology #Gastroenterology #GI #hepatology #SBP #Ascites #Cirrhosis #Translocatin #BacterialOvergrowth #Paracentesis #Peritonitis #Permeability
How do calcium channel blocks (e.g., amlodipine) cause edema? #pathophysiology #physiology #cardiology #cardiotwitter #Nephrology #renal #Neph #edema #CCB #amlodipine #Starling #cirrhosis
How does diabetes mellitus (DM) lead to an increased risk of infection? #pathophysiology #endocrinology #endo #InfectiousDisease #ID #Diabetes #DM #Sorbitol #Polyol #NADPH
Why do we use Vitamin C (ascorbic acid) to promote iron absorption? #pathophysiology #hematology #iron #ironabsorption #VitaminC #ascorbicacid #PPI
Why does influenza have a “seasonal” trend with a winter peak #MedEd #histmed #question #pulmonology #ID #InfectiousDisease #pulm #influenza #flu #FluSeason
Why is cancer associated with elevated lactate dehydrogenase (LDH)? #pathophysiology #HemeOnc #oncology #IM #cancer #lactate #dehydrogenase #LDH #pyruvate #lactate #glycolysis #glucose
How can we make use of the MCH and MCHC provided with most complete blood counts? #Pathophysiology #Hematology #Heme #HemeOnc #MCH #MCHC #MeanCorpuscularHemoglobin #MeanCorpuscularHemogloblinConcentration #CBC
Why is too much oxygen (hyperoxia) harmful? #Pathophysiology #Pulmonology #Pulm #Anesthesiology #Hyperoxia #SupplementalO2 #SupplementalOxygen #OxygenToxicity #Oxygyen
Why is tricuspid valve (TV) endocarditis more common in those who use intravenous drugs? #Pathophysiology #Nephrology #Renal #Neph #Endocarditis #TricuspidValve #TVendocarditis #IVDU #IVdrugUser
Why does acute pulmonary embolism (PE) cause hypoxia? #Pathophysiology #Hematology #Heme #HemeOnc #Pulmonology #Pulm #Hypoxia #PE #PulmonaryEmbolism
Why makes cancer a hypercoagulable state? #Pathophysiology #Hematology #Heme #HemeOnc #Cancer #Hypercoagulable
Why does alcohol make you urinate so much? And, is there any truth to the bar admonition: “don’t break the seal!”? #Pathophysiology #Nephrology #Renal #Neph #Alcohol #IncreasedUrineOutput #ADH #Vasopressin #AntiDiureticHormone
Why hasn’t group A strep (GAS) developed resistance to penicillin? #Pathophysiology #InfectiousDisease #ID #Syphilis #Penicillin #PenicillinResistance #PCN #TreponemaPallidum
Why does giant cell arteritis (GCA) have a predilection for the temporal artery? #Pathophysiology #Rheumatology #Rheum #VascularSurgery #Vascular #GCA #GiantCellArteritis #TemporalArteritis #Vasculitis
Why doesn’t unfractionated heparin (UFH) increase the PT/INR? #Pathophysiology #Hematology #Heme #HemeOnc #Heparin #PTINR #PT #UnfractionatedHeparin
Why does it seem like MRSA is more virulent than MSSA? #Pathophysiology #Nephrology #Renal #Neph#MRSA #MSSA #StaphAureus #Staph
Why does gout preferentially affect the big toe? #Pathophysiology #Rheumatology #Rheum #Gout #BigToe #GreatToe #GoutyArthritits
Should I consider atrial fibrillation a risk factor for pulmonary embolism? #Pathophysiology #Cardiology #CardioTwitter #Afib #AtrialFibrillation #PulmonaryEmbolism #PE #Anticoagulation
“Why do my fingers get all wrinkly when I take a bath?” This was the question my 3-year-old daughter asked me recently after bath time. #Pathophysiology #Vascular #Vasoconstriction #WrinkledFingerTips
Why hasn’t syphilis developed resistance to penicillin (PCN)? #Pathophysiology #InfectiousDisease #ID #Syphilis #Penicillin #PenicillinResistance #PCN #TreponemaPallidum
Have you ever wondered by we don’t use steroids to treat acute pancreatitis (AP)? I have! #Pathophysiology #EBM #Gastroenterology #GI #Surgery #GenSurg #Pancreatitis #Steroids #cytokines #AcutePancreatitis
How does an understanding of the [Na+] of normal saline inform the concept of “pseudohyponatremia”? #Pathophysiology #Nephrology #Renal #Neph #pseudohyponatremia #hyponatremia #normalsaline #NS
Why do patients with hyperbilirubinemia become jaundiced? Patients with hemochromatosis don’t get “scleral bronze”. Why does bilirubin “do” what it does? #Pathophysiology #Gastroenterology #GI #Hyperbilirubinemia #Jaundice #hemochromatosis
Why does herpes simplex virus type 1 (HSV-1) encephalitis localize to the temporal lobe? #Pathophysiology #InfectiousDisease #ID #Neurology #Neuro #HSV #HSVencephalitis #Encephalitis #HSV1 #temporallobe
Why doesn’t pneumonia (or other issues with gas diffusion) lead to increased pCO₂? #Pathophysiology #question #Pulmonology #Pulm #Pneumonia #Hypoxia #pCO2 #gasdiffusion #hypoxemia #hypercapnia #pO2
Why doesn’t the stomach digest itself? #Pathophysiology #Gastroenterology #GI #StomachAcid #GastricAcid
Why does nephrotic syndrome (NS) present with periorbital edema? #Pathophysiology #Nephrology #Renal #Neph #NephroticSyndrome #PeriorbitalEdema
Ever wonder: Why are abdominal aortic aneurysms (AAAs) more common than thoracic aortic aneurysms (TAAs)? #Pathophysiology #VascularSurgery #Vascular #Cardiology #CardioTwitter #AAA #TAA #AbdominalAorticAneurysms #ThoracicAorticAneurysms
Why do patients with acute hemorrhage become anemic? #Pathophysiology #EmergencyMedicine #EM #Surgery #GenSurg #Hemorrhage #Anemia #AcuteHemorrhage
Why isn’t insulin administered orally? #pathophysiology #endocrinology #IM #insulin #diabetes #big #peptide #hydrophillic
Why does HIV cause an elevated protein gap? #PAthophysiology #Infectiousdisease #ID #HIV #AIDS #ProteinGap #Hypergammaglobulinemia
How does aortic stenosis cause syncope? #Pathophysiology #Cardiology #CardioTwitter #Syncope #AorticStenosis
How does one create a Tweetorial? This is thread ONE of a THREE PART series. #MedEd #MedTweetorial #Research #CreatingTweetorialsPart1
How does one create a Tweetorial? This is thread TWO of a THREE PART series. #MedEd #MedTweetorial #Research #CreatingTweetorialsPart2
Why does E. coli clear from the blood faster than S. aureus? #Pathophysiology #InfectiousDisease #ID #EColi #StaphAureus #Staph #ReticuloendothelialSystem #MPS #MononuclearPhagocyteSystem
How does one create a Tweetorial? This is thread THREE of a THREE PART series. III. Tools I use when creating a Tweetorial #MedEd #MedTweetorial #Research #CreatingTweetorialsPart3
How do diuretics lead to metabolic alkalosis? #Physiology #Cardiology #CardioTwitter #Nephrology #Renal #Neph #Diuretics #MetabolicAlkalosis #ContractionAlkalosis