The Curious Clinicians

A curious dive into why certain autoimmune antibodies activate the thyroid instead of blocking it. They trace historical discoveries, experiments that revealed a stimulating factor, and how the TSH receptor gets hijacked. The conversation covers receptor promiscuity, pregnancy links, variable antibody types shaping disease, and mechanisms behind persistent eye disease.

Why check TSH in new atrial fibrillation and what thyroid levels do to the heart. Data linking subclinical and overt hyperthyroidism with increased AF risk. How T3 alters sympathetic tone, atrial electrophysiology, and pulmonary vein triggers. Long-term inflammation and fibrosis as possible drivers of sustained arrhythmia. Interactions with levothyroxine and amiodarone, plus treatment uncertainties.

A lively dive into why tricuspid valve infections are common in people who inject drugs. They explore hemodynamics, endothelial injury, and how turbulent flow and particulates damage the tricuspid valve. Experiments and animal studies that prove injury precedes infection are discussed. The lung’s filtering role and why pulmonic and left‑sided valves are usually spared are highlighted.

A clinical pearl about why active lupus often shows high ESR but low CRP. A clear contrast between what ESR and CRP actually measure. Discussion of cytokine signatures that suppress CRP, including interferon pathways and TLR activation. Practical use of the ESR:CRP ratio to hint at infection versus autoimmune activity.

Cold and flu season greetings from the Curious Clinicians! We hope you all are cold-free, but we were unfortunately under the weather this week. In honor of our "heme boards" series from Hannah's PGY-6 year, we decided to reboot this PGY-1 "intern question" that taught us all a new word. We will be back in 2 weeks with our regularly scheduled new episodes! Show notes for this episode are here!

Dive into the fascinating story of John Hageman and his mysterious coagulation case from the 1950s. Explore why his prolonged clotting time stumped doctors, eventually leading to the discovery of factor XII. Learn about the peculiar role of this factor in the coagulation cascade and its surprising dispensability in vivo. The conversation also touches on factor XII's potential as a thrombosis prevention tool and its evolutionary significance. Get ready for a captivating blend of medical history and science!

This discussion dives into the mysterious world of familial fatal insomnia, revealing its devastating effects on sleep. Avi explains why sleep is vital for brain health and immunity, tracing its evolutionary roots across species. The thalamus is highlighted for its critical role in sleep regulation, with autopsy findings showing its neuronal death. Prion proteins and their mutations are explored, alongside cutting-edge therapies like CRISPR and doxycycline trials. The personal stories of researchers add a touching layer to the science.

Dive into the intriguing world of cirrhosis and its effects on ascites! Discover why cirrhosis leads to high SAAG levels despite leaky capillaries. Explore where ascites originates and the 'weeping liver' hypothesis that explains fluid dynamics. Learn about the impact of portal hypertension and how TIPS procedures can alleviate symptoms. The discussion highlights fascinating medical findings and clarifies the complexities surrounding liver conditions.

This discussion dives into the extraordinary bacterial species Deinococcus radiodurans, renowned for its extreme radiation resistance. It highlights its remarkable DNA repair mechanisms, including multiple genome copies that act as backups. The conversation also explores the evolutionary aspects of its resilience, linking it to potential life beyond Earth. Lastly, it touches on the implications of extremophiles in astrobiology and the risks of bio-contamination when exploring other planets.

Join Dr. Mike Todorovic, an associate professor and medical educator, as he dives into fascinating insights from his book, The Body A-Z. He explains why people with Parkinson's can bike ride effectively, connecting it to basal nuclei circuits and dopamine. Dr. Mike also explores the hiccup reflex, revealing quirky remedies, including an unusual rectal massage. Learn why rigor mortis causes stiffness and the science behind it. His engaging educational philosophy emphasizes simplifying complex topics, making learning entertaining and accessible!