12 episodes

The official podcast of Chubbyemu. Heme Review is a podcast about case reports in medicine. Each episode will tell a patient’s story, while teaching about the pathogenesis of disease, the treatment modalities and the dilemmas that arise during their care. Support this podcast: https://anchor.fm/chubbyemu/support

Heme Review Chubbyemu

    • Medicine
    • 5.0 • 179 Ratings

The official podcast of Chubbyemu. Heme Review is a podcast about case reports in medicine. Each episode will tell a patient’s story, while teaching about the pathogenesis of disease, the treatment modalities and the dilemmas that arise during their care. Support this podcast: https://anchor.fm/chubbyemu/support

    The Body After Eating Several Pounds Licorice Candy

    The Body After Eating Several Pounds Licorice Candy

    Based on N Engl J Med 2020; 383:1263-1275. https://www.nejm.org/doi/full/10.1056/NEJMcpc2002420

    Video version of this podcast: https://youtu.be/8lGmvFkAMOU

    Chubbyemu video of this case: https://youtu.be/qg76qIZ4BQ8

    Laxative Brownie video from 2017: https://youtu.be/TMy0vJfKvzI

    Tweet me: https://twitter.com/hemereview 

    IG me: https://instagram.com/hemereview 

    FB me: https://facebook.com/hemereview

    Licorice candy has glycyrrhizin which increases cortisol (stress hormone) levels in the body. This causes hypokalemia. Hypo- low. Kal- kalium (potassium). emia- presence in blood. Potassium signals muscle relaxation. Low potassium, low relaxation. Heart can't relax, then it stops.  Real licorice candy is not easy to get in the United States. It's not at big chain grocery stores. Most of what you can buy from the big brands is licorice flavored, and won't do this.


    A 54-Year-Old Man with Sudden Cardiac Arrest. N Engl J Med 2020; 383:1263-1275. https://www.nejm.org/doi/full/10.1056/NEJMcpc2002420

    The Pharmacological Activities of Glycyrrhizinic Acid (“Glycyrrhizin”) and Glycyrrhetinic Acid. Sweeteners. 2018 : 245–261. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7123798/

    Sustained Leukocyte Count during Rising Cortisol Level. Acta Haematologica 118(2):73-6. https://www.researchgate.net/publication/6298458


    Licorice-Induced Hypermineralocorticoidism. N Engl J Med 1991; 325:1223-1227. https://www.nejm.org/doi/full/10.1056/NEJM199110243251706

    Young WF, et. al. Apparent mineralocorticoid excess syndromes (including chronic licorice ingestion). In: UpToDate, Post, TW (Ed), UpToDate, Waltham, MA, 2019.

    Quinkler M, Stewart PM. Hypertension and the cortisol-cortisone shuttle. J Clin Endocrinol Metab 2003; 88:2384.

    Funder JW. Apparent mineralocorticoid excess. J Steroid Biochem Mol Biol 2017; 165:151.

    Funder JW. 11 beta-Hydroxysteroid dehydrogenase: new answers, new questions. Eur J Endocrinol 1996; 134:267.


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    • 20 min
    TikTokers Taking Too Much Benadryl

    TikTokers Taking Too Much Benadryl

    YouTube Video Version: https://youtu.be/ZNA_NtcutYY

    Chubbyemu Video: https://youtu.be/NaAFOrudj0g


    The Pharmacology and Use of H1-Receptor-Antagonist. N Engl J Med 1994; 330:1663-1670

    Advances in H1-Antihistamines. N Engl J Med 2004; 351:2203-2217

    Cardiac arrest caused by diphenhydramine overdose. Acute Med Surg. 2018 Oct; 5(4): 380–383.

    IV Lipid Emulsion Infusion in the Treatment of Severe Diphenhydramine. Am J Case Rep. 2019 May 29;20:758-763.

    Diphenhydramine with Intraventricular Conduction Delay Treated with Hypertonic Sodium Bicarbonate and IV Lipid Emulsion. West J Emerg Med. 2014 Nov; 15(7): 855–858.

    Diphenhydramine in a 26-year-old Woman. J Emerg Nurs. 2008 Dec;34(6):543-4.


    Support this podcast: https://anchor.fm/chubbyemu/support

    • 11 min
    Heatstroke (from a Bitcoin Mining Accident)

    Heatstroke (from a Bitcoin Mining Accident)

    YouTube Video Version: https://youtu.be/QSXzRWiuvxE

     Chubbyemu video of this case ▶️ https://youtu.be/fr8bp8a2QS4

    The Body After Drinking A Snowglobe ▶️ https://youtu.be/elzijduKNS8

    The Body After 2 Gallons Coffee In 3 Hours ▶️ https://youtu.be/rn-WLpa_nyQ

    Tweet me: https://www.twitter.com/hemereview

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    Music by  @Lifeformed 

    Heatstroke is a serious problem and the heatwaves that cause it, claim more lives on average than any other weather event in USA. While generally thought to affect the elderly and the very young, it can affect people of all ages, not just because of the heat in the environment (classic heatstroke) but also because of activity (exertional heatstroke). The problems caused by heatstroke sometimes happen but don't appear clinically, like GI ischemia.

    Bitcoin is a decentralized cryptocurrency that's used in peer to peer transactions. This happened in 2011 when individual people could still mine coins, but now, miners are usually pools or in large facilities in places that have cheap electricity and cool climate to save on computer cooling costs.

    The followup: https://web.archive.org/web/20110612111539/http://www.bitcoinminingaccidents.com/


    0 Heat Stroke. Compr Physiol 5:611-647, 2015.

    1 Heatstroke N Engl J Med 2019; 380:2449-2459.

    2 Mechanisms of circulatory and intestinal barrier dysfunction during whole body hyperthermia. Am J Physiol Heart Circ Physiol 280: H509–H521, 2001.

    3 The Impact of Mild Heat Stress During Prolonged Running On Gastrointestinal Integrity, Gastrointestinal Symptoms, Systemic Endotoxin and Cytokine Profiles. Int J Sports Med 2018; 39: 255–263.

    4 Heat stroke: Role of the systemic inflammatory response. J Appl Physiol (1985). 2010 Dec;109(6):1980-8.

    5 Endotoxaemia in exhausted runners after a long-distance race. S Afr Med J. 1988 May 7;73(9):533-6.

    6 Pathogenesis of nonocclusive ischemic colitis. Ann Surg. 1986 Jun;203(6):590-9.


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    • 19 min
    Methanol Hand Sanitizer

    Methanol Hand Sanitizer

    Methanol-contaminated hand sanitizer has been on sale in the USA during COVID-19 pandemic. The FDA has issued a warning against this, and have listed the brands. Most stores that are selling these brands have pulled them from shelves.

    Methanol is a toxic alcohol that can cause blindness. Its antidote is ethanol, which is the alcohol that people drink casually, however management needs to be done by a healthcare professional, as methanol hangs around in the body for several days.

    The case presented here predates the pandemic by almost 20 years. However, methanol skin absorption has been identified as an industrial work hazard since the early 20th century.

    Heme Review YouTube Channel: https://www.youtube.com/channel/UCNSoNc9s67nfOGlCXSu5VsA

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    [0] Case report: Percutaneous absorption and distribution of methanol in a homicide. J Ana Toxicol. 2005 Oct;29(7):734-7. https://pubmed.ncbi.nlm.nih.gov/16419410/

    [1] FDA Methanol List: https://www.fda.gov/drugs/drug-safety-and-availability/fda-updates-hand-sanitizers-consumers-should-not-use

    [2] B.Dutkiewicz, J.Konczalik, and W.Karwaki. Skin absorption and per os administration of methanol in men. Int. Arch. Occup. Environ. Health 47(1): 81-88 (1980).

    [3] Material Safety Data Sheet. SNAP Octane Booster, Product #8-290, SNAP Products Inc. Pandora, OH, 1993.


    Support this podcast: https://anchor.fm/chubbyemu/support

    • 16 min


    This episode is about the pathophysiology on crystallopathies. The cellular pathways involved unify multiple concepts and multiple branches of medicine, from toxicology to cardiology to rheumatology and oncology.

    Heme Review YouTube Channel: https://www.youtube.com/channel/UCNSoNc9s67nfOGlCXSu5VsA


    [0] Crystallopathies. N Engl J Med 2016; 374:2465-2476. https://www.nejm.org/doi/full/10.1056/NEJMra1601611

    [1] Recent advances in the mechanisms of NLRP3 inflammasome activation and its inhibitors. Cell Death & Disease. Volume 10, Article number: 128 (2019). https://www.nature.com/articles/s41419-019-1413-8

    [2] The Inflammasome. Molecular Cell. VOLUME 10, ISSUE 2, P417-426, AUGUST 01, 2002. https://www.cell.com/molecular-cell/fulltext/S1097-2765(02)00599-3

    [3] Silica crystals and aluminum salts mediate NALP-3 inflammasome activation via phagosomal destabilization. Nat Immunol. 2008 Aug; 9(8): 847–856. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2834784/

    [4] Tumor Cell–Derived IL1β Promotes Desmoplasia and Immune Suppression in Pancreatic Cancer. Cancer Res 2020;80:1088–101. https://cancerres.aacrjournals.org/content/80/5/1088


    Support this podcast: https://anchor.fm/chubbyemu/support

    • 15 min
    The Body After Drinking A Snowglobe (High Anion Gap Metabolic Acidosis)

    The Body After Drinking A Snowglobe (High Anion Gap Metabolic Acidosis)

    Video version of episode: https://www.youtube.com/watch?v=elzijduKNS8

    Chubbyemu case: https://youtu.be/UrbylXMU8Mw 

    Most snowglobes are just made of water, but some can contain ethylene glycol. Most of those usually don't contain enough ethylene glycol to cause damage, but keep the word "usually" in mind. A homemade snowglobe can contain concentrations of anything, which is what happened in this case.

    Ethylene glycol can cause a profound high anion gap metabolic acidosis, and we'll explain the science, chemistry and physiology behind that in this episode.


    Delayed ethylene glycol presenting with abdominal pain and multiple cranial and peripheral neuropathies: a case report. Journal of Medical Case Reports volume 4, Article number: 220 (2010).

    Multiple Cranial Nerve Deficits After Ethylene Glycol. Ann Emerg Med. 1991 Feb;20(2):208-10. https://pubmed.ncbi.nlm.nih.gov/1996809/

    Antidotes OH that form toxic metabolites. Br J Clin Pharmacol. 2016 Mar; 81(3): 505–515. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4767193/

    Toxic Alcohols. N Engl J Med 2018; 378:270-280. https://www.nejm.org/doi/full/10.1056/NEJMra1615295

    Ethylene glycol ingestion masked by concomitant ethanol ingestion. Case Reports 2012;2012:bcr1220115326. https://casereports.bmj.com/content/2012/bcr.12.2011.5326

    Challenges in the Diagnosis of Ethylene Glycol Poisoning. Ann Clin Biochem. 2014 Mar;51(pt2):167-78. https://pubmed.ncbi.nlm.nih.gov/24215789/

    Emmett M, Narins RG. Clinical use of the anion gap. Medicine (Baltimore) 1977;56:38-54.

    Uribarri J, Oh MS, Carroll HJ. D-lactic acidosis: a review of clinical presentation, biochemical features, and pathophysiologic mechanisms. Medicine (Baltimore) 1998;77:73-82.

    Judge BS. Metabolic acidosis: differentiating the causes in the poisoned patient. Med Clin North Am 2005;89:1107-1124.

    Kosten TR, O’Connor PG. Management of drug and alcohol withdrawal. N Engl J Med 2003;348:1786-1795. https://www.nejm.org/doi/full/10.1056/NEJMra020617

    A 49 Year Old Man With Obtundation Followed By Agitation And Acidosis. N Engl J Med 2015; 372:465-473. https://www.nejm.org/doi/full/10.1056/NEJMcpc1410940

    Integration of Acid-Base And Electrolyte Disorders. N Engl J Med 2014; 371:1821-1831. https://www.nejm.org/doi/full/10.1056/NEJMra1215672

    Calcium Kidney Stones. N Engl J Med 2010; 363:954-963. https://www.nejm.org/doi/full/10.1056/NEJMcp1001011


    Support this podcast: https://anchor.fm/chubbyemu/support

    • 18 min

Customer Reviews

5.0 out of 5
179 Ratings

179 Ratings

Charles_X ,

Best medical podcast ever!

I love this podcast and your Youtube channel! The detailed biochemical explanations and history behind each of the case studies is wonderful - it’s so obvious that you’ve put tons of time into researching every detail. Thank you so much for the amazing content and I’ll be excited to listen to your future podcasts.

lipstick@23 ,

i love it

its like i am watching the house md in a real action.

twoods218 ,

Cool YouTube video and neat podcast

After watching the medical videos, I flipped to the old videos that this channel has. I enjoy all of the content that has been produced since 2015. I aspire to fasten my diet as he would do in his older videos. Thanks for all the interesting content. Personally, I’m from the Chicago suburbs, and it’s really cool seeing that someone from the Chicago suburbs has made such thought-provoking and aspiring content. Thank you.

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