Rotations 2.0

Todd Fredricks DO MSS
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A weekly discussion of medicine and science trends between people far too old to be trying something this new.

  1. 1D AGO

    Rotations 2.0 Episode 61 Otitis Media

    Send us Fan Mail Episode 61 Otitis Media Shoot me any comments or questions @Rotation2ptoh  on X Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025 Outro Music: Innovation by Alex Grohl Courtesy of Pixabay under Creative Commons non-commercial use. Produced by: Todd Fredricks DO MSS  Edited by: Todd Fredricks DO MSS Answers for Episode 60 Mononucleosis  Question 1 — Diagnostic strategy early in illness A 19‑year‑old college student presents on day 3 of fever, severe sore throat, fatigue, and posterior cervical lymphadenopathy. A rapid heterophile (Monospot) test obtained today is negative. Her CBC shows 52% lymphocytes with 12% atypical lymphocytes. She does not take regular medications. Which of the following is the most appropriate next step? C. Order Epstein–Barr virus (EBV) viral capsid antigen (VCA) IgM/IgG serology Question 2 — Therapeutics and special situations A 17‑year‑old with confirmed infectious mononucleosis has progressive tonsillar hypertrophy, drooling, and muffled voice but maintains oxygen saturation at 97% on room air. Which of the following is the best next step? A. Administer a short course of systemic corticosteroids Question 3 — Return‑to‑play and splenic complications A 20‑year‑old linebacker is diagnosed with infectious mononucleosis after 5 days of symptoms. He is afebrile today and wants to play in next week’s game. Which statement is most accurate for counseling? C. Most splenic ruptures occur within the first 21 days of symptom onset, and ~90% occur by day 31; therefore, no athletic activity should occur for the first 3 weeks Paper for Next Week: Caldwell, Jane M., Nathan A. Ledeboer, and Bobby L. Boyanton Jr. 2024. “Review: Known, Emerging, and Remerging Pharyngitis Pathogens.” The Journal of Infectious Diseases 230, Supplement 3: S173–S181. Rotations  2.0 is copyrighted. But you can use any content from the podcast for non-commercial purposes under Creative Commons….BUT, BUT, BUT, you must cite Rotations 2.0 and Todd Fredricks DO MSS as the source of the material AND AND AND you cannot alter or edit the content in any manner without expressed permission of Todd Fredricks DO MSS Rotations 2.0 is made possible by the generous understanding and accommodation of my beloved institution, Ohio University. The comments and ideas expressed on Rotations 2.0 are that of the content creators alone and may not reflect official policy or the opinion of the Ohio University, the State of Ohio, or the US Government or any other state, person or governmental agency. Listeners interested in specifics from the paper authors should contact them directly through their respective institutions. Any therapeutic ideas discussed should not be taken as any kind of medical advice or recommendations by the content creators and the content creators are not offering medical advice but discussing topics from an academic perspective. Listeners seeking advice about any medical care or decision-making should consult their own physician or medical provider and the content creators of Rotations 2.0 assume no liability for any listener's care or decision-making stemming from the topics discussed on Rotations 2.0.

    45 min

  2. 6D AGO

    Rotations 2.0 Point Episode 59.2 Protecting Medical Part II

    Send us Fan Mail Episode 59.2 Protecting Medical Part II Shoot me any comments or questions @Rotations2ptoh  on X Intro/Outro: Night Detective by Amaksi Courtesy of Pixabay under Creative Commons for non-Commercial Educational use only. Produced by: Todd Fredricks DO MSS  Edited by: Todd Fredricks DO MSS Papers referenced: Erickson, Jon V. “Operating in a Multidomain Environment: Combat Support Training Exercise 86‑24‑02.” Military Review (January–February 2025): 96–102. Crowley, Julie, and John S. G. Wells. “Assaulting Medical Neutrality: Reflections on Attacks on Healthcare and Clinicians in the Two World Wars and Implications for Contemporary Conflicts.” Nursing Inquiry 32 (2025): e70052. https://doi.org/10.1111/nin.70052. If you are interested in this topic I have assembled quite a resource set, please contact me at fredrick@ohio.edu and I can provide you with them. Rotations  2.0 is copyrighted. But you can use any content from the podcast for non-commercial purposes under Creative Commons….BUT, BUT, BUT, you must cite Rotations 2.0 and Todd Fredricks DO MSS as the source of the material AND AND AND you cannot alter or edit the content in any manner without expressed permission of Todd Fredricks DO MSS Rotations 2.0 is made possible by the generous understanding and accommodation of my beloved institution, Ohio University. The comments and ideas expressed on Rotations 2.0 are that of the content creators alone and may not reflect official policy or the opinion of the Ohio University, the State of Ohio, or the US Government or any other state, person or governmental agency. Any therapeutic ideas discussed should not be taken as any kind of medical advice or recommendations by the content creators and the content creators are not offering medical advice but discussing topics from an academic perspective. Listeners seeking advice about any medical care or decision-making should consult their own physician or medical provider and the content creators of Rotations 2.0 assume no liability for any listener's care or decision-making stemming from the topics discussed on Rotations 2.0.

    47 min

  3. MAR 30

    Rotations 2.0 Episode 60 Mononucleosis

    Send us Fan Mail Shoot me any comments or questions @Rotation2ptoh  on X Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025 Outro Music: Cloud Atlas by Alex Grohl Courtesy of Pixabay under Creative Commons non-commercial use. Produced by: Todd Fredricks DO MSS  Edited by: Todd Fredricks DO MSS Answers for Episode 58 Abcesses Question 1 – Diagnosis of Early Lyme Disease A 42‑year‑old woman from Pennsylvania presents with 5 days of fever, fatigue, headaches, and diffuse myalgias. She denies noticing a tick bite. Physical examination reveals no rash. Initial two‑tier Lyme serology (ELISA + Western blot) is negative. Which of the following is the most accurate interpretation of this test result? C. Serologic testing is often insensitive in early Lyme disease, and a negative early test does not exclude infection Question 2 – Persistent Symptoms After Treatment A 33‑year‑old man was treated for early Lyme disease 9 months ago with a standard course of doxycycline. He now reports debilitating fatigue, impaired concentration, unrefreshing sleep, and intermittent musculoskeletal pain that have persisted for 6 months and interfere with daily life. Which of the following features best supports the diagnosis of Post‑Treatment Lyme Disease Syndrome (PTLD)? B. Prolonged symptoms affecting functional ability ≥6 months after standard treatment Question 3 – Antibiotic‑Refractory Lyme Arthritis A 55‑year‑old woman presents with persistent right‑knee swelling 3 months after completing two courses of oral doxycycline for Lyme arthritis. Synovial fluid analysis shows an inflammatory profile but no bacterial growth. Which mechanism best explains her persistent joint inflammation? C. Persistence of Borrelia peptidoglycan antigenic debris that promotes ongoing inflammation Paper for Next Week: El Feghaly, R. E., Nedved, A., Katz, S. E., & Frost, H. M. (2023). New insights into the treatment of acute otitis media. Expert Review of Anti-infective Therapy, 21(5), 523–534.  Rotations  2.0 is copyrighted. But you can use any content from the podcast for non-commercial purposes under Creative Commons….BUT, BUT, BUT, you must cite Rotations 2.0 and Todd Fredricks DO MSS as the source of the material AND AND AND you cannot alter or edit the content in any manner without expressed permission of Todd Fredricks DO MSS.  Rotations 2.0 is made possible by the generous understanding and accommodation of my beloved institution, Ohio University. The comments and ideas expressed on Rotations 2.0 are that of the content creators alone and may not reflect official policy or the opinion of the Ohio University, the State of Ohio, or the US Government or any other state, person or governmental agency. Listeners interested in specifics from the paper authors should contact them directly through their respective institutions. Any therapeutic ideas discussed should not be taken as any kind of medical advice or recommendations by the content creators and the content creators are not offering medical advice but discussing topics from an academic perspective. Listeners seeking advice about any medical care or decision-making should consult their own physician or medical provider and the content creators of Rotations 2.0 assume no liability for any listener's care or decision-making stemming from the topics discussed on Rotations 2.0.

    40 min

  4. MAR 25

    Rotations 2.0 Point Episode 59.1 Protecting Medicine Part I

    Send us Fan Mail Episode 59.1  Intro to Protecting Providers Part 1 Shoot me any comments or questions @Rotations2ptoh  on X  Intro/Outro: Night Detective by Amaksi  Courtesy of Pixabay under Creative Commons for non-Commercial Educational use only  Produced by: Todd Fredricks DO MSS  Edited by: Todd Fredricks DO MSS References  Full episode references available upon request just email me at fredrick@ohio.edu  Rotations  2.0 is copyrighted. But you can use any content from the podcast for non-commercial purposes under Creative Commons….BUT, BUT, BUT, you must cite Rotations 2.0 and Todd Fredricks DO MSS as the source of the material AND AND AND you cannot alter or edit the content in any manner without expressed permission of Todd Fredricks DO MSS The comments and ideas expressed on Rotations 2.0 are that of the content creators alone and may not reflect official policy or the opinion of the Ohio University, the State of Ohio, or the US Government or any other state, person or governmental agency. Any therapeutic ideas discussed should not be taken as any kind of medical advice or recommendations by the content creators and the content creators are not offering medical advice but discussing topics from an academic perspective. Listeners seeking advice about any medical care or decision-making should consult their own physician or medical provider and the content creators of Rotations 2.0 assume no liability for any listener's care or decision-making stemming from the topics discussed on Rotations 2.0.

    39 min

  5. MAR 23

    Rotations 2.0 Episode 59 Lyme Disease

    Send us Fan Mail Episode 59 Lyme Disease Shoot me any comments or questions @Rotation2ptoh  on X Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025 Outro Music: Touch by Alex Grohl Courtesy of Pixabay under Creative Commons non-commercial use. Produced by: Todd Fredricks DO MSS  Edited by: Todd Fredricks DO MSS Answers for Episode 58 Abcesses A 26‑year‑old woman reports recurrent painful deep nodules in both axillae that have persisted for 4 months despite topical care. Which feature from the Lancet review most directly supports a clinical diagnosis of hidradenitis suppurativa in this patient? C. Persistence of one or more active lesions for at least 3 months. According to the review, which comorbidity is most commonly associated with hidradenitis suppurativa and is reported in up to half of affected patients, warranting routine screening? C. Metabolic syndrome Which of the following systemic therapies approved for moderate‑to‑severe hidradenitis suppurativa acts primarily by inhibiting tumor necrosis factor (TNF)? D. Adalimumab Paper for Next Week: Sylvester, J. E., Buchanan, B. K., & Silva, T. W. (2023). Infectious mononucleosis: Rapid evidence review. American Family Physician, 107(1), 71–78.  Rotations  2.0 is copyrighted. But you can use any content from the podcast for non-commercial purposes under Creative Commons….BUT, BUT, BUT, you must cite Rotations 2.0 and Todd Fredricks DO MSS as the source of the material AND AND AND you cannot alter or edit the content in any manner without expressed permission of Todd Fredricks DO MSS. Rotations 2.0 is made possible by the generous understanding and accommodation of my beloved institution, Ohio University. The comments and ideas expressed on Rotations 2.0 are that of the content creators alone and may not reflect official policy or the opinion of the Ohio University, the State of Ohio, or the US Government or any other state, person or governmental agency. Listeners interested in specifics from the paper authors should contact them directly through their respective institutions. Any therapeutic ideas discussed should not be taken as any kind of medical advice or recommendations by the content creators and the content creators are not offering medical advice but discussing topics from an academic perspective. Listeners seeking advice about any medical care or decision-making should consult their own physician or medical provider and the content creators of Rotations 2.0 assume no liability for any listener's care or decision-making stemming from the topics discussed on Rotations 2.0.

    36 min

  6. MAR 16

    Rotations 2.0 Episode 58 Abcesses

    Send us Fan Mail Shoot me any comments or questions @Rotation2ptoh  on X Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025 Outro Music: Sidewinder by Alex Grohl Courtesy of Pixabay under Creative Commons non-commercial use.  Produced by: Todd Fredricks DO MSS  Edited by: Todd Fredricks DO MSS Answers for Episode 57 Cellulitis Question 1 A 68-year-old man is evaluated for recurrent lower extremity cellulitis. In counseling him about prognosis, you reference a 24-year CDC analysis of cellulitis-related mortality in U.S. adults aged ≥65 years from 1999 to 2023. According to this study, which of the following best describes the trend in age-adjusted mortality rates (AAMR per 1,000,000 population) over the study period? C) Overall increase with a steep rise from 2019 to 2023 Question 2 During a public health lecture, you discuss disparities in cellulitis-related mortality among older U.S. adults (≥65 years) based on a recent 24-year CDC WONDER analysis. Which demographic group had the highest age-adjusted mortality rate (AAMR per 1,000,000 population) in this study? C) Non-Hispanic White individuals Question 3 A 72-year-old patient from a rural Midwest community presents with cellulitis. You consider population-level risk factors from a 24-year CDC analysis of cellulitis mortality in older adults. In which of the following settings was cellulitis-related age-adjusted mortality highest? D) Nonmetropolitan (rural) areas Paper for Next Week: Bobe, Jason R., Brandon L. Jutras, Elizabeth J. Horn, Monica E. Embers, Allison Bailey, Robert L. Moritz, Ying Zhang, Mark J. Soloski, Richard S. Ostfeld, Richard T. Marconi, John Aucott, Avi Ma’ayan, Felicia Keesing, Kim Lewis, Choukri Ben Mamoun, Alison W. Rebman, Mecaila E. McClune, Edward B. Breitschwerdt, Panga Jaipal Reddy, Ricardo Maggi, Frank Yang, Bennett Nemser, Aydogan Ozcan, Omai Garner, Dino Di Carlo, Zachary Ballard, Hyou‑Arm Joung, Albert Garcia‑Romeu, Roland R. Griffiths, Nicole Baumgarth, and Brian A. Fallon. “Recent Progress in Lyme Disease and Remaining Challenges.” Frontiers in Medicine 8 (2021): Article 666554.  Rotations  2.0 is copyrighted. But you can use any content from the podcast for non-commercial purposes under Creative Commons….BUT, BUT, BUT, you must cite Rotations 2.0 and Todd Fredricks DO MSS as the source of the material AND AND AND you cannot alter or edit the content in any manner without expressed permission of Todd Fredricks DO MSS. Rotations 2.0 is made possible by the generous understanding and accommodation of my beloved institution, Ohio University. The comments and ideas expressed on Rotations 2.0 are that of the content creators alone and may not reflect official policy or the opinion of the Ohio University, the State of Ohio, or the US Government or any other state, person or governmental agency. Listeners interested in specifics from the paper authors should contact them directly through their respective institutions. Any therapeutic ideas discussed should not be taken as any kind of medical advice or recommendations by the content creators and the content creators are not offering medical advice but discussing topics from an academic perspective. Listeners seeking advice about any medical care or decision-making should consult their own physician or medical provider and the content creators of Rotations 2.0 assume no liability for any listener's care or decision-making stemming from the topics discussed on Rotations 2.0.

    44 min

  7. MAR 9

    Rotations 2.0 Episode 57 Cellulitis

    Send us Fan Mail Episode 57 Cellulitis Shoot me any comments or questions @Rotation2ptoh  on X Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025 Outro Music: Dark Countdown my Head in the Clouds by Alex Grohl Courtesy of Pixabay under Creative Commons non-commercial use. Produced by: Todd Fredricks DO MSS  Edited by: Todd Fredricks DO MSS  Answers for Episode 56 Herpes Simplex Question 1 A 58-year-old man who underwent allogeneic hematopoietic cell transplantation 3 months ago presents with painful vesicular lesions on the vermilion border of the lower lip that have persisted despite 10 days of high-dose intravenous acyclovir (10 mg/kg every 8 hours) with documented adherence and adequate renal dosing. Viral culture confirms HSV-1. Which of the following is the most appropriate next step in management? C) Obtain genotypic or phenotypic drug susceptibility testing and consider transition to foscarnet or cidofovir pending results  Question 2 A 45-year-old woman with a history of solid organ transplantation is hospitalized for recurrent genital HSV-2 lesions unresponsive to 14 days of appropriately dosed intravenous acyclovir. Phenotypic susceptibility testing shows an EC₅₀ within the susceptible range, yet lesions continue to worsen. Which of the following is the most likely explanation for this clinical-phenotypic discordance? A)   Presence of an undetected minority drug-resistant variant within the viral quasispecies  Question 3 In the management of suspected acyclovir-resistant HSV infection in an immunocompromised patient, which of the following statements regarding alternative antiviral agents is most accurate according to current evidence? A) Pritelivir and amenamevir are generally well tolerated with fewer adverse effects than foscarnet or cidofovir and do not require thymidine kinase activation  Paper for Next Week: Sabat, R., Alavi, A., Wolk, K., Wortsman, X., McGrath, B., Garg, A., & Szepietowski, J. C. (2025). Hidradenitis suppurativa. Lancet, 405, 420–438.  Rotations  2.0 is copyrighted. But you can use any content from the podcast for non-commercial purposes under Creative Commons….BUT, BUT, BUT, you must cite Rotations 2.0 and Todd Fredricks DO MSS as the source of the material AND AND AND you cannot alter or edit the content in any manner without expressed permission of Todd Fredricks DO MSS. Rotations 2.0 is made possible by the generous understanding and accommodation of my beloved institution, Ohio University. The comments and ideas expressed on Rotations 2.0 are that of the content creators alone and may not reflect official policy or the opinion of the Ohio University, the State of Ohio, or the US Government or any other state, person or governmental agency. Listeners interested in specifics from the paper authors should contact them directly through their respective institutions. Any therapeutic ideas discussed should not be taken as any kind of medical advice or recommendations by the content creators and the content creators are not offering medical advice but discussing topics from an academic perspective. Listeners seeking advice about any medical care or decision-making should consult their own physician or medical provider and the content creators of Rotations 2.0 assume no liability for any listener's care or decision-making stemming from the topics discussed on Rotations 2.0.

    46 min

  8. MAR 2

    Rotations 2.0 Episode 56 Herpes Simplex

    Send us Fan Mail Episode 56 Herpes Simplex Shoot me any comments or questions @Rotation2ptoh  on X Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025 Outro Music: Traces in Time by Alex Grohl Courtesy of Pixabay under Creative Commons non-commercial use. Produced by: Todd Fredricks DO MSS  Edited by: Todd Fredricks DO MSS Answers for Episode 55 HIV AIDS Question 1 — Policy shock and key populations A public health team in a sub‑Saharan African country reports that PrEP coverage among key populations exceeds 10%. During a funding review, several policy changes are proposed. Which change is most likely to produce the largest immediate rise in new HIV infections among key populations?  B. The government suspends PEPFAR‑funded PrEP services specifically for key populations, including female sex workers, MSM, transgender women, and people who inject drugs. Question 2 — Prevention paradox and PrEP efficiency A regional primary‑care consortium is planning PrEP scale‑up. Epidemiologic data show incidence is approximately 3 per 100 person‑years in the target cohort. Approximately how many individuals must receive PrEP to prevent one new HIV infection under these conditions?  B. Thirty‑three people must receive PrEP to prevent one infection. Question 3 — Integration, equity, and clinical outcomes A community clinic serving diverse patients with HIV is reevaluating its care model. Among its patients are transgender women on ART with variable adherence. Which programmatic change is most likely to improve viral suppression rates in this group according to evidence cited in the editorial? C. Integrate HIV care with gender‑affirming care, including provision of exogenous estrogen therapy as clinically appropriate. Paper for Next Week: Faheem, M. S. B., Munir, S. U., Javed, M., Hassan, S. T., Masood, M. B., Maryam, K. U. E., Cheema, S., Samadi, S., & Khan, M. I., Mortality trends for cellulitis-related death in older adults in the United States: 24-year CDC analysis of gender, race, and geographical disparities. Annals of Medicine & Surgery, (2025).  87, 8471–8477.  Rotations  2.0 is copyrighted. But you can use any content from the podcast for non-commercial purposes under Creative Commons….BUT, BUT, BUT, you must cite Rotations 2.0 and Todd Fredricks DO MSS as the source of the material AND AND AND you cannot alter or edit the content in any manner without expressed permission of Todd Fredricks DO MSS. Rotations 2.0 is made possible by the generous understanding and accommodation of my beloved institution, Ohio University. The comments and ideas expressed on Rotations 2.0 are that of the content creators alone and may not reflect official policy or the opinion of the Ohio University, the State of Ohio, or the US Government or any other state, person or governmental agency. Listeners interested in specifics from the paper authors should contact them directly through their respective institutions. Any therapeutic ideas discussed should not be taken as any kind of medical advice or recommendations by the content creators and the content creators are not offering medical advice but discussing topics from an academic perspective. Listeners seeking advice about any medical care or decision-making should consult their own physician or medical provider and the content creators of Rotations 2.0 assume no liability for any listener's care or decision-making stemming from the topics discussed on Rotations 2.0.

    44 min
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A weekly discussion of medicine and science trends between people far too old to be trying something this new.

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  • Creator
    Todd Fredricks DO MSS
  • Years Active
    2025 - 2026
  • Episodes
    72
  • Rating
    Explicit
  • Copyright
    © 2026 Rotations 2.0
  • Show Website
    Rotations 2.0