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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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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
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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)
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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.
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?
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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,
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Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025
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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?
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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:
, “Diverticulitis: A Review of Current and Emerging Practice-Changing Evidence” (2024;37:359–367):
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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.
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Intro Music: KI Instrumental (Rock Celtic) by Lyrium-2025
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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:
Podcasts Similaires Basées sur le Contenu
Découvrez des podcasts liées à Rotations 2.0. Explorez des podcasts avec des thèmes, sujets, et formats similaires. Ces similarités sont calculées grâce à des données tangibles, pas d'extrapolations !
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.
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.
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.
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.
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.
Sonia Wu, Maher Al Khaldi, Carole S. Richard, François Dagbert
Clinics in Colon and Rectal Surgery
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.
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.
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.
