The Body After Drinking A Snowglobe
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- เผยแพร่เมื่อ 19 ก.ค. 2020
- A Dad Mistakenly Drank A Snowglobe. This Is What Happened To His Kidneys: • A Dad Mistakenly Drank...
A Man Drank 2 Liters Moonshine In 2 Hours. This Is what Happened To His Brain: • A Man Drank 2 Liters M...
The Body After Drinking 2 Gallons Coffee In 3 Hours: • The Body After 2 Gallo...
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Additional photos courtesy Radiopaedia.org, and Wellcome Collection.
Pathology slides courtesy BMJ Case Reports, September 12 2019
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.
References:
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. pubmed.ncbi.nlm.nih.gov/1996809/
Antidotes OH that form toxic metabolites. Br J Clin Pharmacol. 2016 Mar; 81(3): 505-515. www.ncbi.nlm.nih.gov/pmc/arti...
Toxic Alcohols. N Engl J Med 2018; 378:270-280. www.nejm.org/doi/full/10.1056...
Ethylene glycol ingestion masked by concomitant ethanol ingestion. Case Reports 2012;2012:bcr1220115326. casereports.bmj.com/content/2...
Challenges in the Diagnosis of Ethylene Glycol Poisoning. Ann Clin Biochem. 2014 Mar;51(pt2):167-78. pubmed.ncbi.nlm.nih.gov/24215...
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. www.nejm.org/doi/full/10.1056...
A 49 Year Old Man With Obtundation Followed By Agitation And Acidosis. N Engl J Med 2015; 372:465-473. www.nejm.org/doi/full/10.1056...
Integration of Acid-Base And Electrolyte Disorders. N Engl J Med 2014; 371:1821-1831. www.nejm.org/doi/full/10.1056...
Calcium Kidney Stones. N Engl J Med 2010; 363:954-963. www.nejm.org/doi/full/10.1056... - วิทยาศาสตร์และเทคโนโลยี
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Correction!
Ethanol and its related metabolites at 1:08, 2:25, 2:50
are all drawn with an extra carbon. Apologies!
Nobody is perfect.👍Hey, it is ok. No
Thanks for pointing that out :)
Thank you for the work you're doing. I know it doesn't have as much views as your main channel but as a med student I love this podcast and it sometimes helps me or makes me remember things. I really look forward to the next episode and bisous from france !
Okay, was about to comment that xD, these things happen :)
@@renkomon.8312 😂
"No one ever forgets their high school chemistry titration experiments"
You overestimate us
I mean, I remember I did them. And that our teacher was usually drunk. And he was sleeping with a biology teacher with a funny name.
@@hkr667 Ok... good for you?
That implies that we did titration in my class
lmfao i just did my first one two weeks ago,, and not even the full experiment because my equipment was faulty
Neh I do remember. I remember we kept making "What In Titration" memes
excuse-me, but where is the supposedly mandatory "mitochondria is the powerhouse of the cells" disclaimer?
Ahhh yes casually drinking a snow globe and not saying anything about it
This stuff is so interesting even though ill never remember any of it.
You can if you try. We believe in you!
LMAO SAME
Samee
I remember parts and thats mostly like don't do this or you will have lots of organ failure
You guys didn't take chemistry in High School? This is just basic stuff.
One of the liver's functions: break down toxic chemicals so they can be excreted safely.
Liver: *metabolizes a relatively harmless chemical and turns it into a poison*
Body: You had ONE JOB
.
.
.
(Also yes I know that the liver has WAAAAY more than one job.)
Liver doesn't care if it can be voided without breaking down: it only cares that it can break it.
@@kohlrak like a tough as nails Russian boxer. He will break you or die trying.
liver on a power trip. it just wants to break things
Liver doesn't care if it makes things more or less poisonous. Liver only cares about making things more water-soluble to help the kidneys deal with them.
I know that this is a niche event, but could you do an episode looking at a victim of the Austrian Wine Poisoning if possible? I was always fascinated by the irony of ethanol being the cure for the antifreeze wine. Great video btw!
It's hard to look at a victim if there is none. The scandal was one because they used something what they weren't supposed to use. That's it. No one was harmed by it back then.
@@Lucy-tw4bf i thought that there were tens of victims and at least 1 death attributed to it.
@@Lucy-tw4bf There were multiple victims though?..
(just in case you haven't seen it yet) the moonshine video covers the competitive reaction between ethanol and methanol (or ethylene glycol, propylene glycol). Ethanol outcompetes all of them in first pass metabolism, iirc.
@@fevre_dream8542 this was a house episode also
this is the sequel to the lava lamp video that we didn't know we needed
Even the dad didn't need it!!!!😂
The mitochondria is the powerhouse of the cell.
And -emia means presence in blood!💖
I grew up surrounded by medical textbooks and listening to my dad's continuing education CDs, provided by Audio Digest. I wasn't cut out to follow in my parent's footsteps, but I never lost interest in the medical world. Aside from asking my dad for those Audio Digest disks, your channels are the single most valuable things for scratching that itch and renewing my love for the beauty of the human body. Your videos, be they about power lifting, life advice, or toxicology/anatomy have been such a wonderful thing for me over the last few years. I hope you have many happy years ahead of you, Doctor, and that you feel the joy and enthusiasm that I and so many others get when we see you've uploaded another banger.
They also get me through the boring parts of my work day so thanks for that too
I hope the Doc has a chance to come back and read your comment!
Luke, mister Stone, did you go to Arcata High?
"Cation"
My brain: Tiny charged particles with domestic feline characteristics. 🐱
"Take care of yourself and be-" *TH-cam ad starts* "PIZZA OR SALAD"
Every hospital needs someone who gets this stuff - a real life version of "House." If not, then they should have digital access to someone who knows these things, thereby having a consultant on hand when needed. Wonder why the EMT people didn't mention the snowglobe, not blaming them, but think how much quicker he could have been diagnosed if but for that one bit of information.
There IS no real life version of House, never will be.
@@looksirdroids9134 Not really. You can make one. You need to find a very high-intelligence person, and give them medical information without exposing them to hospital culture. Thus, you have someone willing to hunt zebras when they do show up. Vicodin addiction optional.
Watson AI is made for this, it should be implemented more widely
Pentalarclikesit could you explain what you mean by giving them medical information but keeping them unexposed to the culture?
@@SuperSmith Think about it: People who have to spend day to day in the hospital will have both a set of standard medical teachings and defaults ("don't chase zebras" "x is usually y" "patients who think they have y usually have z" etc. and can become cynical to the same things due to peer influence. (Think people from x neighboorhood are druggies? Someone not working at that hospital, in that town has never heard of the place. The guy in charge that everyone wants to impress doesn't like x medication, or y people, or z diagnosis, people will automatically tend to go the same way, (90%) or the exact opposite (10%). People are always molded by their peers and by their sociological environment. It's simple human nature. We develop blind spots and assumptions. And if a certain group of people are missing a diagnosis, it likely falls into one of those blindspots.
I so wanted to study medicine. I would rise and sleep with that thought. I’m 45 and that ship has done set sail. Now, I watch your videos vicariously enjoying what you’re living. That being said, I’m one of your biggest fans 👍🏼
@ Robert Costello:
At age 45, how has the 'medicine-ship' already set sail? It still looks well-moored from here.
Lana Harlow Thank you for being kind, but with the kids and and all those payments due, I haven’t the time to rest... never mind going back to school. 🙏🏼 but again, your kind words made me smile 😊
Lana Harlow the reason is because it takes 12 years total to be a doctor- 4 for premed, 4 for medical school and usually 4 years for residency (sometimes seven). They stop hiring doctors with little experience shortly after 40, and stop putting contracted doctors down for so many hours at ER's shortly after they're 55. If you're 60 and own your own private practice, they expect several decades of experience, not for you to come right out of medical school. Sure, Robert can go to school and waste hundreds of thousands of dollars to become a doctor to only never be able to pay it back due to how competitive and strenuous the job is because he'll be 57 by the time he'll actually be able to practice medicine.
Kat Howard “I much prefer the sharpest criticism of a single intelligent person to the thoughtless approval of the masses.”- Johannes Kepler. That was masterful. Thank you for putting it in words better than I can. 🙏🏼
could always be a pharmacist. I know folks who started late in life down that path
Honestly watched it a couple times so I could understand it. Learning more here than 4 years of chem tbh
But its only been 15 minutes-
@@linkedius2532 2X speed bb
Robby P ah facts
this makes me feel smarter
Lol yeah.
Poor kakyoin.... He really was a.... GEM
@@synchrolord B) thx
I really like the channel name, more content from you is always good
So if ethylene glycol is a positive allosteric modulator of gaba, I guess he did reduce his withdrawals to an extent... at quite a cost
Allosteric modulators require orthosteric binding to exert effect. No?
@@MrZacharykgwin - Well, yes, any modulator would have to bind to take effect.
@@ElectronFieldPulse I meant in order for an allosteric modulator to exert effect it needs an orthosteric agonist, antagonist, etc... Otherwise nothing will happen if the allosteric is the only thing bound to the receptor
@@MrZacharykgwin - Yes, you are correct, I just think that people automatically assume that given the dependent nature of allosteric modulators and how they work. Not much good on their own.
@@ElectronFieldPulse indeed. The applications atleasts in drug development could be immense.
I use your videos to understand my biochemistry and the ADH example you gave before helped me a ton.
This whole time I thought the liquid in snow globes was just water.
14:15 "but there isnt good data out there on why this happens" this is bad. id think there is an overwhelming demand for researchers to understand and publish the inner workings of tons of different interactions within the body. yikes
It surprises me that there are actually many things we don't know in our body while we have so many paper publish every year.
@@firerocket7343 They are complicated problems. If you think it should be so easy, go join a lab and try to advance the knowledge base yourself! Not a negative comment, I genuinely want people to dive into the literature.
It is a tribute to how complex the human body is. Research is at an all-time high, but there are still many things to be understood due to complexity, not due to the lack of an overwhelming demand.
@@SelectHawk I did not say it should be easy. You take my comment negatively.
It's partly a matter of funding. Pharmacutical companies focus on research likely to produce drugs they can sell, so they don't often do this sort of basic research. That leaves funding from goverments and some privet foundations, and much of that is targeted at research likely benifit large numbers of people. I don't know how many people a year get ethylene glycol poisoning, but I doubt it's common enough to attract much intrest from potential sorces of funding
I had a friend who was an alcoholic. He died of alcoholic ketoacidosis at age 35. The irony is that he was a chemist and getting a PhD in human physiology.
not ironc. addiction is strongly linked to stress, and medical professionals are no exception.
what an odd! I know a dude since i was 6 who is an avid drinker for over 30+ years. Now at Age 50, Still alive and drunker than ever! it all started to increase from casual to daily since he’s 43. As he got wealthier man.. every time i visited his office it’s all expensive liquor on table! But hey at least i can grab some🙃
The channel name is genius though
5:25 I love this fact, it's a combustion reaction basically, we breath out the CO2 and excrete the water resulted from "burning" the fat (or sugars for that matter.) This is related in my mind to the fun fact that the vast majority of the mass that makes up trees actually comes from carbon they pull from CO2 from the atmosphere, since they're made of a lot if cellulose. I love that our fat is similar, so the fat I burn off at the gym could become part of a nearby tree 😁😊
I really love your videos, I watch them religiously, I think you’re legit one of the best medical you tubers who genuinely does it to help spread knowledge and awareness to both the lay person and people with a medical background. I’ve been studying for my steps and you help make some concepts easy to understand and help visualize. Never stop uploading.
Brings back memories, Dr. Bernie. Your diagnostic approach has a lot of parallels in engineering and troubleshooting engineered equipment. Nice to see people think in Medicine
People who say that engineering doesn't involve "life and death" are too general. Good engineering saves lives and saves jobs and careers.
35 years ago winerys in Austria used ethylene glycol to artificially adult the wine, some people even went to jail
So, I’m crocheting a baby blanket while listening to these videos.
I hope all the knowledge I listen to will be woven into the blanket, and the kid will grow up to be the next ChubbyEmu, simply by sleeping with the blanket. Because that’d be awesome.
Or at the least, just a smart kid.
Moral of these vids. Ima make sure i Always have lots of Ethanol in my system so i cant get poisoned.
Thanks for helping me review a little bit of chem/Biochem while I’m studying for the MCAT
one of youtube's best
I am shocked to hear this patient made it after such a trauma to his kidneys. Starting this, I was afraid he would succumb to sepsis, from kidney failure or brain death from poisoning and coma. Alcoholism is a sad and scary disease to think the lengths one would go to ingesting such a toxic substance. I wish this channel was around when I was studying for my State Conference Funeral Director/Embalmer Board Exams, and in school. I am not practicing now due to chronic illness, but still like to keep up with the medical terminology and anatomy in all aspects. The human body is amazing.
You're amazing Dr. you should develop a course for Doctors' and other health professionals on how to better explain to patients of their conditions and treatment.
Outstanding content doctor!
Always had a soft spot for Edgar Allan Poe: I was born on his death date (month and day). October is my favorite month.💖
Back in the day I used to HATE biology. But now because of Chubby's videos I have memorized almost all the terms he has said and I would've became a doctor IF my addiction with electronic things and tech was not there. Keep up the good work!
Oh I didnt know the yt heme review videos had visualizations of the content. Just came from the audio exclusive ep!
This stuff is so interesting! I love these deep dive styled videos looking into medical cases. Heck, part of me wants to study it more in depth. Keep up the great work, mate!
The ethanol diagrams in the video and the one on chubbyemu show porpanol. Ethanol should only have one 120 degree "bend". (incorrect diagram at 1:10) The glycol diagram is correct, though
Also the acetaldehyde...
I wish TH-cam still had overlaid annotations for this reason. Factual errors need to be corrected at the source since TH-cam is everyone's teacher now.
I love the name of this channel! Truly amazing content as well.
Love your content! Glad I found your other channel! Love learning new things!
Come to learn chemistry here😀
I love your videos! I binge watched them before every pathophysiology and pathology exam to review. They are well made and very helpful. Thank you for making such amazing videos!
after watching so much forensic files 20 years ago in college, as soon as you mentioned crystals in the kidneys I said to myself "its ethylene glycol!!!"
The organic chemistry and molecular biology jargon is so well done and really is easy to follow along with. So this is why I took those courses 😁💡!! Thank you extra study/refreshing material and a professional point of view. You rock Dr!!
I always look forward to seeing your next video thank you for sharing your wisdom.
I have been enjoying your videos for quite a while but I always hoped for a "more medical" version of them, which goes further into detail, this is great!
I've always been a fan of your content but I have a newfound appreciation for them [the vids] now that I'm delving into the realm of chemistry. There's a lot of shit I have trouble remembering and I realized that when I have something to actually apply that concept to-bam, I got it! that shit sticks, you know? :)) so lol, I literally use your content as study material as weird or corny as that may sound. I've realized that teaching/educating others is truly a fucking SKILL and after consuming countless lectures where it seems as though the speaker is more focused on putting material out there for their peers instead of the STUDENTS they're actually talking to..well, it just really put that into perspective for me! I think your 'audience' is something you really keep in mind judging from the format of your material, and I'm absolutely grateful for that! Thanks again, and please keep up with the great production! You're out here killin' it, my dude..entertaining aand educating:') All the best, EC
This is so easy to grasp. You are already a great teacher.
I always wondered what the anion gap was. I went through kidney failure and was on dialysis for a year before I got a kidney transplant. I always liked to look up and learn what the different blood tests meant and I always had a high anion gap. Now I know the chemistry of why I had metabolic acidosis. Really interesting thank you!
I hope that you're doing well.
@@ramseydoon8277 Thank you for checking on me. Yes I am still doing well, going 3 years strong on my transplant now! I hope you are doing well too!
I love these 2nd videos to the main channel going more in depth, makes it easier to understand and is very interesting
GOD bless you. you're now officially my professor and mentor!
This video's so high-IQ, it's making my head hurt.
No, it's just a sign that maybe you should study more.
@@kashinimeyo Allow me to point out for you that this comment is based on a meme format from the anime "Dr. Stone", since you apparently aren't aware of that. With that being said, have a nice day.
@@kashinimeyo nah bro we just dumb 😔
@@White742
Yes, cause chemistry is obviously where it's really at :P
Glad I found this channel. I love these explanations!
Being able to follow this video makes me feel like my first two semesters of college have been worth it :,)
It is the 100th time I learn the Acidosis-Alcalosis stuff, and it will be the 100th time I'll totally forget what it is.
Your videos are so amazing . Medicine is so intresting and there is so much to learn everyday , I am actually considering going to a Med University because i enjoy learning anatomy and everything related to the human body . You are doing a great job , keep up the good work :)
I like how the further on in education I get, the more relevant my chemistry knowledge becomes in these videos
Recently there was several cases of ethylene glycol intoxication in Brazil due to problems related to the production of a certain beer brand. Something related to the anti-freeze machine.
Thank you. I like this presentation format.
Wow, I've been watching your other channel for a while and didn't realize you had this one too. Guess I should sub to this one too haha!
I think the ethanol structure is incorrect. It looks like propanol
He mentioned it was a mistake...on the other hand, oxalate can bind to more than just one calcium ion...the multiple calcium-oxalate complexes form a lattice characteristic of the crystals that form in the kidneys
@@brandonveltri2825
Well yes and no. If you take an individual oxalate molecule, it would bind to one calcium, but a crystal is of course a microscopic megastructure where the kations and anions are strictly organized in a grid, therefore distributing the charges not just between two counterparts, but every surrounding particles.
JayHill the two carboxylates from one oxalate can bind to at least 2 calcium ions as bidentate coordination complexes...technically it can stabilize 4 Ca2+ ions between itself and another oxalate
Your channel is better chemistry class than HS and university.
great vid man. learned quite a bit
I honestly like these videos where you explain why ingesting X material is bad, in detail. I always look forward to them.
By the way, have you ever had a patient that drank gasoline/diesel/some other petrochem product? If you have, I'm wondering if you would be willing to do a video about it?
If I'm recalling correctly, oxalic acid is the component of spinach that gives it the strange mouth feel. Oxalic acid in the spinach reacts with calcium ions on your tongue/teeth and in saliva, giving it the "fuzzy" feeling as it forms micro crystals.
I'm a medical lab student in Canada and we learned MUDPILES this year as causes of high anion gap (something we see a lot). GOLDMARK was taught as an additional acronym but it never appears on exams, its always MUDPILES. I had no idea GOLDMARK was newer/better.
I’m finally using my languishing organic chemistry knowledge 🙏🏻
I noticed some goofs but I’m not gonna fret.
Med school couldn't teach me Anion gap properly and here we are in TH-cam academy learning medicine like it's actually science and not just facts that you gotta memorize, thanks to creators like you, so thank you !🙏🏼😅
I am so jealous at the level of your intelligence. That being said, please take me to your leader ✌🏼
Good gravy! You are one smart fella! Hubby and I drink decay tea everyday, obviously we haven't drank to much, but what is wrong with tea and how much is too much?
3:10 This song is amazing.
This level of knowledge on body chemistry processes has always been the favorite part of your videos. Is this something a normal MD learns in med school though at this depth? Or is it something you specialize in?
Technically, every MD should know that, at least in Poland, where I study. We have biochemistry for 2 semesters and I'm also pretty sure, that these mechanisms are mentioned on patophysiology. However, after talking to many doctors while on my clinical activities I have realised, that not many MDs remember this kind of stuff - at best, they know cause and consequence of certain processes, like for example glycole ingestion, but most of them think, that knowing the pathway that leads to the consequence is unnecessary. And without repetition, there's no way to remember something that you learned on second year of med school.
About oxalate, there's ongoing debate about whether to eat oxalate rich food (like spinach) with calcium rich food (cheese/ tofu). Some say that the two when eaten together accelerates the body's excretion of the calcium-oxalate salt, while some say that this combination accelerates the formation of kidney stones. What's your opinion on this?
Acid-base relationships, ions and anion gap, metabolic and respiratory acidosis--Knowledge is power. Thx, Dr Bernard.😊💖
Way back I studied Chemistry and Biology, but due to life circumstances at the time, I completely changed my career path. I wasn't bad at science, but my interest in chem/bio withered. Your videos makes me wonder where my life would have taken me if I stayed in science :) I'm very good at what I do now, but your explanations bring me back :)
I’d never fully understood the anion gap until this video. Thank you
Such an educational content! It's always a nice complement to med school. I would love to bring that format to Medical Physiology and Applied Physiological Reasoning classes at my University. Could you help me out?
This is very interesting can’t wait for the next episode
Chubbyemu: eli5
Heme review: Eli doctor
I love your hair, it's so pretty
I enjoy these more informative videos!
Can methanol poisoning also be treated by giving ethonal? Does the body have a higher affinity for ethonal than methanol like it does ethylene glycol?
yes!
@@HemeReview When I was a young corrections officer in Michigan, we had about 15 prisoners from Jackson prison to our medical unit who had consumed methanol. (stolen copy fluid) We had them locked in cells and were giving them double shots of vodka every half hour, even if we had to wake them up, to help their bodies to eliminate the methanol. At first it was a big party, here's the prison giving them vodka. About two hours later, the whole medical unit smells like puke and the only prisoners who weren't refusing to drink more were the old heads who knew better. They talked most of the others to keep drinking. Of the 15 we had transferred to us, two went blind. All of them lived.
Never knew you had a second channel
I wish I had your video's while I was failing chemistry in highschool 😓
Dayum I like your hair like this looks 👌🏻🔥
HI!! Would it be possible for you to do a video looking into and explaining the MTHFR gene mutation and it’s effects/links to thyroid and kidney issues? My family is trying to get tested, as we nearly all have clear symptoms or signs of the mutation, but our family Dr. claims there’s no reason to. :/ (Thank you!)
Can I simplify it to , when our body produces acids it eats up HCO3-(their H+ ) leaving behind their anions so producing an anion gap as well as lowering bicarbonate?
I remember reading about an ethlyene glycol poisoning that caused the calcium oxolate crystals to form in the brain. Pretty terrifying, although we haven't actually covered diols in detail in Organic Chemistry yet.
My brain couldn't process majority of the content but that was great.
Why would the guy wait 6 days to tell the medical team he drank ethylene glycol. OMG. But then anyone willing to drink ethylene glycols not that smart to begin with.
Confused at 9:25-10:00.. why the outcomes (alkalosis vs acidosis) are different when anion level decrease through vomit vs with diuretic..?
I've forgotten my high school titration experiments. They were 52 years ago.
I think it would be cool if you could make a follow-up video on the current state of research on potential treatments for COVID-19. It seems like there is a LOT of conflicting research on a variety of different drugs, including hydroxychloroquine and azithromycin, and it is near impossible to muddle through it all as someone with a high school-level background in biology.
The legendary Pokémon is a deadly alcohol bird
*Chubbyemu is just so extremely intelligent.*
Ooh, ever thought about doing a video on the Elixir Sulfanilamide incident that led to the FDA getting more power to make medications safe? Or would that be an over saturation of alcohol group related videos?
Too many peanuts? As someone who has been known to get though a lot of peanuts at a sitting (so over the cause of a day whilst studying) how much is a lot?
So Dr. Hsu’s clickbaity content is brilliantly thorough, way more than a lot of pop science stuff - and then I find out he does a parallel series without the sensational presentation. This guy.
Can you explain the vapor pressure function and osmolal gap? Why is vapor pressure relevant?
I love your videos!!
Oh yeah yeah
Learning alot.