Rotations 2.0 – Détails, épisodes et analyse

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Episode 49 Carpal Tunnel Syndrome

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Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025

Outro Music: The New Awakening 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 48 Osteoporosis/RA

Question 1

A 64-year-old postmenopausal woman with rheumatoid arthritis presents after sustaining a vertebral fracture. Which factor most strongly contributes to her increased fracture risk compared to age-matched controls?

B. Chronic systemic inflammation activating osteoclasts

 Question 2

According to current recommendations, which patient should undergo bone mineral density (BMD) screening for osteoporosis?

C. A 42-year-old woman with RA taking ≥2.5 mg prednisolone daily for 4 months

Question 3

Which medication is most effective for increasing bone mineral density and reducing vertebral fractures in patients with RA and glucocorticoid-induced osteoporosis?

C. Denosumab

Paper for Next Week:

Michael Kj, Jesper Petersen, Michael Ries Dünweber, Jesper L.vind Andersen, Lars Engebretsen, Stig Peter Magnusso,Dilemma in the Treatment of Sports Injuries in Athletes: Tendon Overuse, Muscle Strain, and Tendon Rupture, Scandinavian Journal of Medicine & Science in Sports, 2025; 35:e70026

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.

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Episode 48 Osteoporosis

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Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025

Outro Music: A Promise Kept 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 47 Fibromyalgia

Question 1: Pathophysiology

A 42-year-old woman presents with chronic widespread pain, fatigue, and cognitive difficulties. Functional MRI reveals increased activation in the posterior insula and secondary somatosensory cortex. Which of the following neurotransmitters is most likely elevated in her cerebrospinal fluid and contributes to her pain hypersensitivity?

B. Substance P

Question 2: Diagnosis

According to the 2016 American College of Rheumatology (ACR) criteria, which of the following combinations is sufficient to establish a diagnosis of fibromyalgia?

C. WPI = 5, SSS = 9, symptoms for 3 months

Question 3: Treatment

A 50-year-old female with fibromyalgia is started on pharmacologic therapy. Which of the following medications is FDA-approved for fibromyalgia and has shown efficacy at doses of 300–600 mg/day?

B. Pregabalin

Paper for Next Week:

Mikahla E. Gay, Jose G. Lima, Vanessa Vieites, Starlie C. Belnap, Richard Morgan
Comparison of Diagnostic Modalities for Carpal Tunnel Syndrome: A Systematic Review, Cureus, September 17, 2025 

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.

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Episode 42 Osteoarthritis

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Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025

Outro Music: Hard Rock to Drive to Survive Adrenaline Sport 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 41 Hemorrhoids

Question 1:

A 45-year-old patient with grade III internal hemorrhoids is concerned about postoperative pain and urinary retention. The surgeon recommends a modified office-based procedure that uses negative pressure and an elastic coil instead of a traditional band. Which treatment is being described?

B. Modified rubber band ligation (RBL)

Question 2:

A patient with grade II hemorrhoids and a bleeding tendency is seeking a minimally invasive treatment with low risk of complications. The physician recommends a sclerosant that has shown high patient satisfaction but carries a rare risk of anaphylactic shock. Which agent is being described?

B. Polidocanol foam

Question 3:

A colorectal surgeon is evaluating treatment options for a patient with grade III hemorrhoids. The goal is to reduce postoperative pain, bleeding, and hospital stay. Which combination of procedures has been shown to achieve these outcomes more effectively than stapled hemorrhoidopexy (SH) alone?

C. SH with Doppler-guided hemorrhoidal artery ligation (DG-HAL)

Paper for Next Week: 

Andrea Di Matteo and Paul Emery, “Rheumatoid arthritis: a review of the key clinical features and ongoing challenges of the disease,” Panminerva Medica, December 2024, Vol. 66, No. 4, pp. 427–442.

 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.

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Episode 41 Hemorrhoids

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Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025

Outro Music: Mellow Future Bass (Bounce on it) 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 40 Diarrhea 

Paper for Next Week: 

Alice Courties, Inès Kouki, Nadine Soliman, Sylvain Mathieu, Jérémie Sellam, Osteoarthritis year in review 2024: Epidemiology and therapy, Osteoarthritis and Cartilage,  32 (2024) 1397–1404

 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.

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Episode 40 Diarrhea

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Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025

Outro Music: Endless Universe (Dreamy Summer) by Alex Grohl

Courtesy of Pixabay under Creative Commons non-commercial use.

Produced by: Todd Fredricks DO MSS 

Edited by: Todd Fredricks DO MSS

“The Ghost Map” by Steven Berlin Johnson, Riverhead 2006

Some good You Tube presentations on this.

“Superiority” by Arthur C. Clarke  https://nob.cs.ucdavis.edu/classes/ecs153-2019-04/readings/superiority.pdf

WHO rehydration formula: https://www.who.int/publications/i/item/WHO-FCH-CAH-06.1

I didn’t discuss POCUS for Hydration Assessment: https://www.pocus.org/inferior-vena-cava-ivc-assessment-for-volume-status-in-point-of-care-ultrasound-pocus-setting/

Answers for Episode 39 Constipation 

Question 1:

A 68-year-old woman with chronic constipation is prescribed magnesium oxide. After several weeks, she presents with lethargy and muscle weakness. Her serum magnesium level is elevated. Which of the following factors most likely contributed to her condition?

C. Delayed colonic transit time

Question 2:

Which of the following medications acts by inhibiting the ileal bile acid transporter (IBAT) and promotes colonic motility through serotonin release?

C. Elobixibat

Question 3:

A randomized controlled trial compared the efficacy of polyethylene glycol (PEG) 3350 to placebo in patients with chronic constipation. What was the reported treatment success rate in the PEG group?

C. 52%

Paper for Next Week:

Sung Il Kang, Latest Research Trends on the Management of Hemorrhoids, Journal of the Anus, Rectum and Colon (2025; 9(2): 179–191):

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.

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Episode 39 Constipation

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Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025

Outro Music: A Comedy Funny (Dream Lullaby) 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 38 Diverticulitis 

Question 1: Pathophysiology and Risk Factors

A 65-year-old male presents with left lower quadrant abdominal pain and fever. CT confirms acute uncomplicated diverticulitis. Which of the following lifestyle factors is most strongly associated with a decreased risk of developing diverticulitis?

C. Vigorous cardiovascular activity

Question 2: Diagnostic Imaging

Which of the following imaging modalities is considered the gold standard for diagnosing acute diverticulitis?

C. Computed Tomography (CT) scan with or without IV contrast

Question 3: Treatment Guidelines

According to recent evidence and guidelines, which of the following patients with acute uncomplicated diverticulitis should still be treated with antibiotics?

C. A 70-year-old immunocompromised patient

Paper for Next Week:

Christopher J. Black & Alexander C. Ford (2025) An evidence-based update on the diagnosis and management of irritable bowel syndrome, Expert Review of Gastroenterology & Hepatology, 19:3, 227-242,

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.

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Episode 38 Diverticulitis

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Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025

Outro Music: Breaking Free by Alex Grohl

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Produced by: Todd Fredricks DO MSS 

Edited by: Todd Fredricks DO MSS

Answers for Episode 37 Cholelithiasis

Question 1: Pathophysiology and Risk Factors

A 45-year-old woman presents with intermittent right upper quadrant pain after meals. She has a BMI of 32 and is on estrogen-containing oral contraceptives. Ultrasound confirms the presence of gallstones. Which of the following best explains the pathophysiology of her condition?

B. Supersaturation of bile with cholesterol leading to crystal formation

Question 2: Diagnostic Imaging

A 60-year-old man presents with fever, jaundice, and right upper quadrant pain. Labs show elevated bilirubin and alkaline phosphatase. Ultrasound reveals gallstones but no ductal dilation. Which imaging modality is most appropriate to both diagnose and treat a suspected common bile duct obstruction?

C. Endoscopic retrograde cholangiopancreatography (ERCP)

Question 3: Pharmacologic Therapy

A patient with asymptomatic cholesterol gallstones is not a surgical candidate. Which of the following pharmacologic agents is most appropriate for attempting gallstone dissolution?

C. Ursodeoxycholic acid (ursodiol)

Paper for Next Week:

Mariko Hojo, Tomoyoshi Shibuya and Akihito Nagahara, Management of Chronic Constipation: A Comprehensive Review, Intern Med 64: 7-15, 2025

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.

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Episode 37 Gallstones

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Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025

Outro Music: Abstract Future Bass Pursuit by Qubesounds

Courtesy of Pixabay under Creative Commons non-commercial use.

 Produced by: Todd Fredricks DO MSS 

Edited by: Todd Fredricks DO MSS

 Answers for Episode 36 Hepatitis

 Question 1: Hepatitis A Prognosis and Management

A 68-year-old man presents with fatigue, jaundice, and elevated liver enzymes. He is diagnosed with acute hepatitis A. Which of the following factors is most associated with increased risk of fulminant hepatitis A and poor prognosis?

C. Advanced age (>75 years)

Question 2: Hepatitis B Treatment Strategy

A 35-year-old man with chronic hepatitis B is started on antiviral therapy. After one year, his HBV DNA is undetectable and he has achieved e-antigen seroconversion. What is the most appropriate next step in management?

C. Continue nucleos(t)ide therapy to reduce relapse risk

Question 3: Hepatitis C Screening and Treatment

A public health initiative aims to reduce hepatitis C prevalence in a U.S. population. Which of the following strategies is supported by recent clinical trial data and national guidelines?

C. Implement universal screening for adults aged 18–79 and treat with pan-genotypic DAAs

Paper for Next Week:

Sonia Wu,  Maher Al Khaldi, Carole S. Richard, François Dagbert, “Diverticulitis: A Review of Current and Emerging Practice-Changing Evidence”  Clinics in Colon and Rectal Surgery(2024;37:359–367):

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.

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Episode 36 Hepatitis

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Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025

Outro Music: Yearning by dferun

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Produced by: Todd Fredricks DO MSS 

Edited by: Todd Fredricks DO MSS

Answers for Episode 35 Inflammatory Bowel Disease

Question 1: Diagnosis and Biomarkers

A 35-year-old patient presents with chronic gastrointestinal symptoms. Endoscopic and histologic findings are inconclusive for either ulcerative colitis or Crohn’s colitis. Which of the following biomarkers is most useful in differentiating Crohn’s colitis from ulcerative colitis in cases of indeterminate colitis?

C. Human alpha defensin 5 (DEFA5)

Question 2: Surgical Management

Which of the following surgical procedures is considered the gold standard for treating refractory ulcerative colitis while preserving fecal continence?

B. Restorative proctocolectomy with ileal pouch-anal anastomosis (RPC-IPAA)

Question 3: COVID-19 and IBD Care

During the COVID-19 pandemic, which of the following strategies was most commonly implemented to maintain continuity of care for patients with inflammatory bowel disease?

C. Virtual consultations and contact center services (CCS)

Paper for Next Week:

Mark W. Jones ; Connor B. Weir ; Mia Marietta, Gallstones (Cholelithiasis) StatPearls [Internet], Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Last Update: June 2, 2025.

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.

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Episode 35 Inflammatory Bowel Disease

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Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025

Outro Music: Comedy Quirky Funny Background Music by Background Music for Videos

Courtesy of Pixabay under Creative Commons non-commercial use.

Produced by: Todd Fredricks DO MSS 

Edited by: Todd Fredricks DO MSS

Answers for Episode 34 Irritable Bowel Syndrome

Question 1: Pathophysiology

A 34-year-old woman presents with chronic abdominal pain and alternating bowel habits. She is diagnosed with IBS. Which of the following findings is most consistent with the current understanding of IBS pathophysiology?

C. Altered gut microbiota and increased visceral hypersensitivity

Question 2: Treatment – IBS-D

A 45-year-old male with IBS-D has failed dietary and lifestyle interventions. He is now being considered for pharmacologic therapy. Which of the following medications is most appropriate as a first-line treatment for diarrhea and abdominal pain?

B. Eluxadoline 100 mg BID

Question 3: Dietary Management

A 29-year-old female with IBS-D reports worsening symptoms after meals. She is interested in dietary interventions. Which of the following is the most evidence-based dietary strategy for symptom relief?

C. Low-FODMAP diet with phased reintroduction

Paper for Next Week:

Matthew August Odenwald and Sonali Paul, Viral Hepatitis: Past, present, and future, World Journal of Gastroenterology, April 14, 2022, 28, 14

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.