Question of the Day – Friday, June 9, 2023
What clinical syndrome can be expected after duckbilled platypus envenomation? The Platypus (Ornithorhynchus anatinus) has spurs located on the hindlegs which are connected to venom ducts. Envenomation results in immediate, severe, pain and swelling. The components of the venom have not yet been clearly…
Question of the Day – Thursday, June 8, 2023
The dermatitis exhibited below is associated with ingestion of which type of mushroom? The dermaitis depicted is associated with ingestion of dried shiitake mushrooms in soup. Kano Y, Shigehara Y, Kasami S, Kato M. Shiitake Dermatitis. Intern Med. 2020 Sep 1;59(17):2203. doi: 10.2169/internalmedicine.4635-20. Epub 2020…
Question of the Day – Wednesday, June 7, 2023
Historical QOD 12/11/08: What abnormalities have been associated with the use of fenfluramine-phentramine? Valvular heart disease. In 1997, researchers at the Mayo Clinic presented a report on 24 patients who developed valvular insufficiency while taking the combination diet pill Fen-phen. The mitral valve was the…
Question of the Day – Tuesday, June 6, 2023
What is Fenethylline? From the cited reference: “Fenethylline also known as amphetaminoethyltheophylline and amfetyline, is a codrug of amphetamine and theophylline, which behaves as a prodrug to both of the aforementioned drugs. It is marketed for use as a psychostimulant under the brand names Captagon,…
Question of the Day – Monday, June 5, 2023
In a recent case report of a patient treated for what authors believed were symptoms of withdrawal from xylazine, what differences did that patient report between her experience using xylazine as opposed to opioids alone? The patient reported that she would often fall asleep right…
Question of the Day – Friday, June 2, 2023
In a recent case report of a patient hospitalized for treatment of chronic lower extremity wounds thought to be due to xylazine injection, what medications were used to treat symptoms which authors attributed to a withdrawal syndrome from xylazine? Dexmedetomidine, tizanidine, phenobarbital, and clonidine. The…
Question of the Day – Thursday, June 1, 2023
Historical QOD 12/10/08: Which cancer has been associated with the use of diethylstilbestrol? Diethylstilbestrol (DES) is a transplacental carcinogen. Maternal use of this synthetic estrogen has been associated with vaginal cancer (clear cell adenocarcinoma) in female offspring. Approximately 0.1% of DES exposed offspring develop vaginal…
Question of the Day – Wednesday, May 31, 2023
How do antiarrhythmics, quinidine affect serum digoxin concentrations? Antiarrhythmics can increase serum digoxin concentrations. For example, quinidine decreases tissue binding of digoxin, leading to smaller volume of distribution and higher serum digoxin concentrations. Quinidine may also interfere with digoxin secretion by inhibiting P-glycoprotein in the…
Question of the Day – Tuesday, May 30, 2023
How do macrolides and tetracyclines affect serum digoxin concentrations? Macrolide antibiotics such as clarithromycin and erythromycin, and tetracyclines such as tetracycline and doxycycine alter the normal flora of the gut, including Eubacterium lentum. Under normal conditions, Eubacterium lentum inactivates digoxin in 10 – 15% of…
Question of the Day – Monday, May 29, 2023
High dose insulin (HDI) improves shock via at least four mechanisms. What are they? 1. HDI acts as a potent inotrope, increasing stroke volume and therefore cardiac output by calcium-dependent and calcium-independent pathways in myocardial cells. 2. HDI optimizes myocardial energy utilization as stressed myocardial…