Clinical Deep Dives

Med School Audio - Medical Knowledge Reimagined & Learning Made Memorable.
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Clinical Deep Dives is a Medlock Holmes podcast for clinicians and learners who want understanding, not just information. Using classic medical and surgical texts as a guide and the generative power of AI, each episode explores ideas with curiosity and clarity, designed for learning on the move and knowledge that actually sticks. drmanaankarray.substack.com

  1. 3 HR AGO

    Micro 51: Reoviruses

    This episode explores the reoviruses, a family of non-enveloped double-stranded RNA viruses with segmented genomes. Drawing from Murray’s Chapter 51, it focuses primarily on rotavirus, a leading cause of severe gastroenteritis in infants and young children. Reoviruses are structurally distinctive: they possess multiple protein layers forming a double capsid shell that protects the segmented RNA genome. Because double-stranded RNA is a potent trigger of innate immune responses, replication occurs within partially intact capsids in the cytoplasm, shielding viral RNA from detection. The segmented genome permits reassortment, contributing to strain variation. Clinically, rotavirus infection results in: * Profuse watery diarrhoea * Vomiting * Dehydration * Severe disease in infants Vaccination has significantly reduced hospitalisations and mortality globally. Conceptually, reoviruses demonstrate structural protection and genomic segmentation as tools of persistence and epidemiologic adaptability. Key Takeaways * Reoviruses are non-enveloped double-stranded RNA viruses * Possess layered capsid structure * Rotavirus is a major cause of paediatric gastroenteritis * Genome segmentation enables reassortment * Vaccination reduces disease burden This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit drmanaankarray.substack.com/subscribe

    40 min

  2. 3 HR AGO

    Micro 50: Rhabdoviruses, Filoviruses, and Bornaviruses

    Episode Description This episode examines three morphologically distinctive families of enveloped negative-sense RNA viruses. Drawing from Murray’s Chapter 50, it explores how structure and tropism define clinical severity. The first focus is rhabdoviruses, particularly rabies virus, characterised by its bullet-shaped virion. Rabies uniquely travels along peripheral nerves to the central nervous system, producing fatal encephalitis if untreated. The slow axonal transport provides a window for post-exposure prophylaxis - a rare example where timing can prevent near-certain mortality. Next are filoviruses, including Ebola and Marburg viruses. These filamentous viruses cause severe systemic disease marked by endothelial dysfunction, immune dysregulation, and haemorrhagic manifestations. High viral replication and cytokine storm contribute to vascular collapse. Finally, bornaviruses, though less commonly encountered, illustrate persistent infection within neural tissue. Conceptually, this chapter demonstrates that viral morphology often reflects transmission and tropism. Clinically, early intervention, isolation, and public health containment are critical. Key Takeaways * Rhabdoviruses include rabies virus, which travels via peripheral nerves * Filoviruses cause severe haemorrhagic fever * Negative-sense RNA genomes require polymerase carriage * Post-exposure prophylaxis can prevent rabies * Strict infection control limits filovirus spread This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit drmanaankarray.substack.com/subscribe

    34 min

  3. 14 HR AGO

    Micro 49: Orthomyxoviruses

    This episode explores the orthomyxoviruses, the viral family that includes influenza viruses. Drawing from Murray’s Chapter 49, it examines how genome segmentation enables evolutionary change and periodic global outbreaks. Orthomyxoviruses are enveloped negative-sense single-stranded RNA viruses with segmented genomes. This segmentation permits reassortment when multiple strains infect the same host cell - the molecular basis of antigenic shift. Two key mechanisms define influenza evolution: * Antigenic drift - gradual mutation of surface glycoproteins * Antigenic shift - abrupt reassortment leading to novel strains The surface proteins haemagglutinin (HA) and neuraminidase (NA) determine viral entry and release. Host range is influenced by receptor specificity and species transmission patterns. Clinically, influenza ranges from self-limited respiratory illness to severe pneumonia and systemic inflammatory complications. Annual vaccination reflects the dynamic nature of antigenic drift. Conceptually, orthomyxoviruses demonstrate that genomic architecture shapes epidemiology. Segmentation equals adaptability. Key Takeaways * Orthomyxoviruses are segmented negative-sense RNA viruses * Antigenic drift results from gradual mutation * Antigenic shift results from reassortment * HA and NA are key surface glycoproteins * Vaccination must adapt to viral evolution This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit drmanaankarray.substack.com/subscribe

    46 min

  4. 14 HR AGO

    Micro 48: Paramyxoviruses

    This episode explores the paramyxoviruses, enveloped negative-sense single-stranded RNA viruses known for their ability to induce cell fusion. Drawing from Murray’s Chapter 48, it examines how viral surface proteins drive respiratory infection and characteristic cytopathic changes. The family includes: * Respiratory syncytial virus (RSV) * Parainfluenza viruses * Measles virus * Mumps virus The defining mechanistic feature is the fusion (F) protein, which allows viral envelopes to merge with host cell membranes and, importantly, promotes the formation of syncytia - multinucleated giant cells created by fusion of infected cells. Clinically: * RSV is a major cause of bronchiolitis in infants * Parainfluenza viruses cause croup * Measles produces systemic infection with rash and immunosuppression * Mumps can affect salivary glands, testes, and central nervous system Conceptually, paramyxoviruses illustrate how membrane fusion facilitates direct cell-to-cell spread, bypassing extracellular immune defences. Vaccination plays a critical preventive role in measles and mumps. Key Takeaways * Paramyxoviruses are enveloped negative-sense RNA viruses * Fusion protein enables syncytium formation * Primarily infect respiratory epithelium * Some cause systemic disease with rash or glandular involvement * Vaccination significantly reduces disease burden This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit drmanaankarray.substack.com/subscribe

    36 min

  5. 1 DAY AGO

    Micro 47: Coronaviruses and Noroviruses

    This episode examines two clinically distinct but epidemiologically powerful viral groups: coronaviruses and noroviruses. Drawing from Murray’s Chapter 47, it explores how structural features drive transmission patterns. The first half focuses on coronaviruses, enveloped positive-sense RNA viruses characterised by crown-like spike glycoproteins. These spikes mediate attachment to host receptors and determine tissue tropism. Human coronaviruses range from mild upper respiratory pathogens to agents of severe lower respiratory disease. The episode discusses replication within respiratory epithelium, immune-mediated lung injury, and the importance of infection control during outbreaks. The second half addresses noroviruses, small non-enveloped positive-sense RNA viruses and leading causes of acute viral gastroenteritis. Their environmental stability, low infectious dose, and efficient faecal–oral transmission enable rapid spread in closed communities. Conceptually, these viruses illustrate two transmission archetypes: * Respiratory droplet spread (coronaviruses) * Environmental and faecal–oral spread (noroviruses) Clinically, containment and supportive care are central, with prevention strategies tailored to mode of transmission. Key Takeaways * Coronaviruses are enveloped positive-sense RNA viruses * Spike proteins determine receptor binding and tropism * Noroviruses are non-enveloped and highly contagious * Transmission route defines outbreak dynamics * Infection control is critical for both This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit drmanaankarray.substack.com/subscribe

    53 min

  6. 1 DAY AGO

    Micro 46: Picornaviruses

    This episode explores the picornaviruses, a large family of small, non-enveloped, positive-sense single-stranded RNA viruses. Drawing from Murray’s Chapter 46, it examines how genomic efficiency enables extensive clinical diversity. The family includes: * Enteroviruses (poliovirus, coxsackieviruses, echoviruses) * Rhinoviruses * Hepatitis A virus The replication strategy is direct and efficient: the positive-sense RNA genome functions immediately as mRNA upon entry into the cytoplasm. Translation produces a single polyprotein that is cleaved into functional viral proteins. Clinically, picornaviruses demonstrate broad tropism: * Respiratory infection (rhinovirus - common cold) * Neurologic disease (poliovirus) * Myocarditis (coxsackievirus) * Gastrointestinal illness * Acute hepatitis (HAV) Conceptually, these viruses illustrate that small genome size does not limit clinical impact. Environmental resilience due to lack of envelope enhances transmission, particularly via the faecal–oral route. Key Takeaways * Picornaviruses are small, non-enveloped positive-sense RNA viruses * Genome acts directly as mRNA * Include enteroviruses, rhinoviruses, and HAV * Broad clinical spectrum * Transmission often faecal–oral or respiratory This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit drmanaankarray.substack.com/subscribe

    34 min

  7. 1 DAY AGO

    Micro 45: Parvoviruses

    Episode Description This episode examines parvoviruses, the smallest human DNA viruses. Drawing from Murray’s Chapter 45, it focuses on how structural simplicity results in highly selective cellular targeting. Parvoviruses are non-enveloped, single-stranded DNA viruses that require actively dividing cells for replication. Their dependence on host DNA polymerase confines them to tissues with high cellular turnover. The clinical focus is Parvovirus B19, which infects erythroid precursor cells in the bone marrow. The consequences vary by host context: * Erythema infectiosum (fifth disease) in children * Transient aplastic crisis in patients with haemolytic disorders * Hydrops fetalis in fetal infection * Arthropathy in adults Conceptually, parvoviruses illustrate that replication dependency shapes disease distribution. Clinically, the same virus can produce benign rash in one host and life-threatening anaemia in another. Key Takeaways * Parvoviruses are small, non-enveloped single-stranded DNA viruses * Replication requires rapidly dividing cells * Parvovirus B19 targets erythroid precursors * Disease severity depends on host condition * Infection may cause fetal complications This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit drmanaankarray.substack.com/subscribe

    40 min

  8. 1 DAY AGO

    Micro 44: Poxviruses

    This episode explores poxviruses, the largest and most structurally complex DNA viruses infecting humans. Drawing from Murray’s Chapter 44, it examines how these enveloped double-stranded DNA viruses uniquely replicate in the cytoplasm rather than the nucleus. The narrative begins with structure: brick-shaped virions containing their own transcriptional machinery. Because they do not rely on host nuclear enzymes, they carry the proteins required for replication and mRNA synthesis. The historical centrepiece is Variola virus, the cause of smallpox - a disease eradicated through global vaccination efforts. Its clinical course, systemic dissemination, and characteristic rash distribution provide a template for understanding viral exanthems. The episode also addresses: * Vaccinia virus as the vaccine vector * Molluscum contagiosum as a common cutaneous infection * Emerging zoonotic poxviruses Conceptually, poxviruses represent viral autonomy - large genomes with encoded enzymatic machinery. Clinically, they illustrate the triumph of coordinated public health intervention. Key Takeaways * Poxviruses are large, enveloped double-stranded DNA viruses * Replication occurs in the cytoplasm * Variola virus was eradicated via vaccination * Vaccinia virus functions as the vaccine platform * Cutaneous lesions are characteristic clinical features This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit drmanaankarray.substack.com/subscribe

    34 min
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About

Clinical Deep Dives is a Medlock Holmes podcast for clinicians and learners who want understanding, not just information. Using classic medical and surgical texts as a guide and the generative power of AI, each episode explores ideas with curiosity and clarity, designed for learning on the move and knowledge that actually sticks. drmanaankarray.substack.com

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  • Creator
    Med School Audio - Medical Knowledge Reimagined & Learning Made Memorable.
  • Years Active
    2K
  • Episodes
    379
  • Rating
    Clean
  • Copyright
    © Dr Manaan Kar Ray
  • Show Website
    Clinical Deep Dives

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