Question of the Day – Thursday, March 24, 2022

What are some risk factors for wooden chest syndrome? Lipophilic opioids (fentanyl, remifentanil, sufentanil), rapid injection, higher doses, age over 60 years, conditions or medications that cause a deficiency of dopamine levels (Parkinson’s disease), medications that increase norepinephrine and serotonin levels. Buxton JA, et al….

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Question of the Day – Wednesday, March 23, 2022

What is the proposed mechanism of wooden chest syndrome? The proposed mechanism of WCS is activation of µ-opioid receptors in the central nervous system (CNS) via a dopaminergic pathway resulting in skeletal muscle rigidity Rosal NR, Thelmo FL Jr, Tzarnas S, DiCalvo L, Tariq S,…

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Question of the Day – Tuesday, March 22, 2022

Long-term methotrexate therapy has been associated with what hepatic effects? Long term therapy with frequent but mild elevations in serum liver enzymes. More importantly, methotrexate has been associated with development of fatty liver and hepatic fibrosis and, in rare instances, portal hypertension and symptomatic cirrhosis….

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Question of the Day – Monday, March 21, 2022

A deficiency of which vitamin can cause degeneration of optic nerve fibers? Vitamin B12. Vitamin B12 deficiency optic neuropathy is a rare complication of this deficiency that results in progressive, bilateral, painless vision loss that is often associated with reduced color vision and central or…

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Question of the Day – Friday, March 18, 2022

What are deterministic versus stochastic health effects of radiation exposure? Deterministic health effects, such as acute radiation syndrome, are those occurring above a dose threshold and increase in severity with an increasing radiation dose. In other words, deterministic health effects are directly related to the…

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Question of the Day – Thursday, March 17, 2022

In a review of the literature of the serotonin toxidrome, the authors elegantly critiqued the diagnostic criteria and reviewed the mechanism and pathophysiology of toxicity. Of the seven serotonin receptors, which two receptors does excess serotonin act on to cause toxicity? It is likely no…

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Question of the Day – Wednesday, March 16, 2022

In a recent review of snake envenomation, the authors discussed venom-induced consumption coagulopathy, which causes a depletion of clotting cascade factors and spontaneous or uncontrolled bleeding. What is the most relevant procoagulant toxin? Metalloproteinases activate prothrombin, factor V, factor X and fibrinogenase. Seifert S, Armitage…

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Question of the Day – Tuesday, March 15, 2022

What are the MRI findings associated with Wernicke’s Encephalopathy? According to the cited reference: “MRI findings are represented by symmetric hyperintensity on T2-weighted and fluid-attenuated inversion recovery (FLAIR) images and corresponding hypointensity or no abnormalities on T1-weighted images within the medial thalami. The thalamic lesions…

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Question of the Day – Monday, March 14, 2022

Consumption of stew containing which mollusk has been associated with development of cardiac glycoside toxicity? Ingestion of stew containing Helix Pomatia (the burgundy snail) has been associated with secondary exposure to cardiac glycosides from Nerium Oleander.  According to the cited reference, after consumption of the…

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Question of the Day – Friday, March 11, 2022

During the 2022 Winter Olympics, a Russian figure skater allegedly tested positive for trimetazidine. What may be the proposed benefit of this drug to improve performance? In a recent randomized trial at high altitude in healthy volunteers, trimetazidine resulted in decreased fatigue and reversed cardiorespiratory…

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