Crackcast & Physicians As Humans On Canadiem

This episode covers Chapter 83 of Rosen's Emergency Medicine.   List 6 RFs for bacterial endocarditis List 5 common bacteria responsible for infective endocarditis Give three examples of immunologic sequelae of IE. Give three examples of vascular sequelae of IE. What are the diagnostic criteria for endocarditis, and how are they used? List 5 lab or investigative findings in bacterial endocarditis Describe the treatment of infective endocarditis List four complications of IE. List the indications for infectious endocarditis prophylaxis. What are the empiric antibiotics used for pts with suspected infectious endocarditis? Describe the Jones Criteria for Acute Rheumatic Fever What is the treatment of rheumatic fever Name three causes of acute mitral regurgitation. How is acute MR managed? What is the pathophysiology of mitral valve prolapse?  How does it present? List four causes of mitral stenosis. List four causes of aortic valve insufficiency. List 3 physical exam findings associated with AS What is critical

This episode covers chapter 82 of Rosen's Emergency Medicine. Take a listen for all those juicy pericardial-pump-pearls!   List eight causes of pericarditis. Describe typical pain of pericarditis, expected lab work abnormalities, What is the typical sequence of ECG changes in pts with pericarditis? (the stages) Describe the treatment of pericarditis associated with: Uremia, Neoplasm, and SLE Outline the management of Dressler's syndrome. What is the pathophysiology of cardiac tamponade? Describe the mechanism of hypotension in pericardial tamponade and list 4 expected findings on physical examination. Describe the procedural steps in pericardiocentesis List 4 causes of pneumopericardium and one specific PEX finding List five causes of constrictive pericarditis. What is the pathophysiology of purulent pericarditis?  List 5 organisms responsible for infectious pericarditis? How is it managed? Describe the pathophysiology of hypertrophic cardiomyopathy Describe the clinical exam and ECG findings associated with

This episode covers Chapter 81 of Rosen’s Emergency Medicine. This one is mint! Heart failure is one of those must-know-about presentations, you WILL see this in the ED.   Define Cardiac index Preload Afterload Describe: How compliance changes the relationship between end diastolic pressures and volume the Frank-Starling relationship Pousseils Law and LaPlaces Law List 3 CV and 4 Neurohormonal physiologic compensatory mechanisms in CHF List the 5 most common disease processes resulting in HF and briefly describe the contribution of each Describe the different classifications of heart failure: Acute vs. Chronic HF Systolic vs. Diastolic dysfunction Right vs. Left sided HF High-output vs. Low-output HF Describe the NYHA function HF Classes and the Killip Classification List 10 common precipitants of acute HF List 6 historical predictors of acute HF and 6 clinical features of acute HF List 5 CXR and 5 ECG findings of HF What is the role of BNP in HF? Describe the primary management goals in acute HF De

This episode covers chapter 80 of Rosen's Emergency Medicine. All those juicy pearls about those funny little [black] boxes in your patients chest.   Chapter 80 – Implantable Cardiac Devices   List 5 Indications for permanent pacing What are common Pacemaker types? Pacemaker nomenclature - what do the 5 letters mean List the causes of pacemaker malfunction (main categories with 2 examples each) List the complications of a pacemaker insertion What is pacemaker pseudo-malfunction? What is pacemaker syndrome, which type of pacer is most commonly involved, and what is the tx? What does magnet application do to a pacemaker? to an ICD? Indications for ICD Causes of shock delivery in patient with ICD Causes of syncope/presyncope in patient with ICD Fxns of an ICD   Wise Cracks   What do you see on ECG when pacer battery dies (2)? What is twiddler’s syndrome? Describe your Approach to LVAD complications Approach to Pacemakers

This episode covers Chapter 79 of Rosen’s Emergency Medicine. All those funny squigly marks on the ECG confusing you? Us too. Here is some knowledge to help you out. What is the blood supply of the following parts of the conduction system: SA node, AV node What are the three pathophysiologic mechanisms for dysrhythmias? What causes & how does AV nodal reentry tachycardia occur? List the classes of antidysrhythmics. Describe their mechanism of action and usual uses, as well as an example of each. How does digoxin work as an antidysrhythmic? When is it used? List underlying etiologies of sick sinus syndrome. What are three ECG presentations of sick sinus syndrome? Define 1° heart block.  List three causes. Differentiate between the two types of  2° heart block with respect to etiology, ECG appearance and management. What is ‘high grade’ heart block?  How is it managed? Describe the difference between AV dissociation & 3° AV block. Compare PAC’s to PVC’s. Give a differential diagnosis of irregularly irr

Here is the follow-up to the mammoth ACS chapter. This one has some key factoids to put into your mind map / memory pallace / organic computer.   List Sgarbossa criteria for AMI in pre-existing LBBB What is Takotsubo cardiomyopathy and how does it present? Describe the kinetics of cardiac biomarkers (Troponins and CK) List DDx for ↑ Troponin What is the utility of CTA in the diagnosis of MI? What is the role of ED-based chest pain centers? List 3 phases of delay in the management of AMI; and describe the time-points in ED management of AMI. What are door-to-needle and door-to-balloon timelines by AHA recommendations? Describe the mechanism of action and indications/contraindications for Nitroglycerin Morphine BBlockers ACE-I Antiplatelet Therapies Anti-thrombins Describe eligibility criteria for Fibrinolytics List contraindications to Fibrinolytic therapy in MI What is the utility of Rescue PCI and Facilitated PCI? List 5 indications for Rescue PCI Describe factors assisting with decision to utilize PCI o

This episode covers Chapter 78 of Rosen's Emergency Medicine. Acute Coronary Syndromes... its a gooder. Acute Coronary Syndromes Part A (Monday) Define Stable Angina, UA, AMI Describe the pathophysiology of AMI What are the components of prehospital management of AMI List population RFs for CAD. Do they matter in the evaluation of a specific patient? List RFs for atypical presentation of ACS. What are the risks of atypical presentations? List 8 early complications of AMI and briefly describe the management of each one. Describe the progression of ECG changes in STEMI List expected ECG changes (ST↑ and reciprocal ST↓) and culprit vessel for the following: Anterior wall MI Lateral wall MI Inferior wall MI RV wall MI Posterior wall MI Describe the ECG characteristics of Left Main Occlusion What is Wellens’ sign and what is it’s significance List 10 DDx for ST-elevation Describe the ECG features of Benign early repolarization Pericarditis LBBB RBBB Ventricular-paced rhythm LVH / Strain-pattern LV aneurysm

This episode covers Chapter 77 of Rosen’s Emergency Medicine. The Pleural Space is not to be trifled with! List 5 RFs for 1° spontaneous PTX.   What is the most common pathophysiologic cause of PTX? List 8 causes of 2° spontaneous PTX List 5 clinical findings suggestive of tension PTX Describe how to estimate the size of a PTX Describe the management of 1° and 2° spontaneous PTX Describe the procedure needle aspiration of a PTX. List 3 benefits of this over TT Describe the procedure of TT. List 6 complications of TT placement and contraindications. List 10 causes of pleural effusion.  What is the most common transudative and exudative? What is starling’s law and how does it apply to the development of pleural effusions List 5 CXR findings of pleural effusion Describe Light’s Criteria for pleural effusion and list 5 other tests to perform on pleural fluid. What does a low pH indicate? Describe the procedure of thoracentesis.  List 2 contraindications and 9 complications   Wise Cracks What is Catamenial pneu

This episode covers Chapter 76 of Rosen’s Emergency Medicine. Have you ever seen pneumonia? Yeah.... we thought so. Now here are all the nitty-gritty details. What are the typical associative pathogens? Describe the typical clinical presentation/RFs/Management for each of the following -S. pneumonia -H. influenzae -Staph aureus -Klebsiella -Mycoplasma pneumoniae & Chlamydia pneumoniae -Legionella -Anaerobes -Pseudomonas -PJP & Other Fungal Pneumsonia -Tuberculosis -Tularemia -Hantavirus List the typical etiologies of viral pneumonia. Which patient groups should receive pneumovax? Which pneumonias can present with cavitating lesions (abscesses) on x-ray What is the differential for possible pneumonia visible on CXR? Describe the analysis of pleural fluid. -Which effusions should be sampled? -What are Light's criteria? What is the CURB65 score?    

This episode covers Chapter 75 of Rosen’s Emergency Medicine.   1. List potential causes of pharyngitis. (List 5 viral and 5 bacterial etiology of pharyngitis) 2. What are the indications for steroids in a patient with pharyngitis? 3. List causes of epiglottitis. 4. What are the deep spaces of the neck? List 4 deep space infections of the neck 5. What are the typical bacterial causes of deep space infections? What are the different syndromes called? 6. What are the potential complications of deep space neck/face infections? List 5. 7. When do the sinuses typically develop? 8. What the pathophysiology of sinusitis? What are the typical pathogens? 9. Describe the management of acute rhinosinusitis and list 6 predisposing factors Wisecracks: List 5 suppurative and 5 non-suppurative complications of GABHS List 4 findings on lateral neck xray of epiglottitis Describe an approach to airway management in deep space neck infections What are lateral neck xray findings suspicious for RPA?

This episode covers Chapter 74 of Rosen’s Emergency Medicine. As Vanilla is to chocolate, COPD is to Asthma. Look for all things wheez-e-y here. Define acute exacerbation Describe GOLD classification for COPD List factors of decompensation or triggers of an AECOPD Name 4 mimics for AECOPD What are the clinical features used to diagnose AECOPD? Describe the ED management of AECOPD. What does the end tidal tracing look like in COPD? List indications and contraindications to NIPPV in COPD Which patients with AECOPD should be treated with antibiotics? Which patients with AECOPD require admission? List indications for intubation for AECOPD   Wise Cracks List 4 CXR and 3 ECG findings in COPD  

This episode covers Chapter 73 of Rosen’s Emergency Medicine. The ancient Greeks knew about Asthma... so should you! We give you all the major points for diagnosis and treatment in the ED.   Sign post   10 different causes of a wheeze. List 8 risk factors for death from asthma List 6 objective findings of severe asthma 10 therapies for an acute severe asthma exacerbation Discuss a ventilation strategy for the critically-ill asthmatic patient Discuss disposition and discharge planning for an acute asthma exacerbation presenting to the ER   Wise Cracks What is delayed sequence intubation? Can it be used for severe Asthma exacerbation? What about pregnancy and Asthma is so important?

This episode covers Chapter 72 of Rosen’s Emergency Medicine. All those pearls you need for ears, masses, nose bleeds and weird stones in weird places. Define Otitis Media Acute Chronic Recurrent Describe the diagnosis treatment of Otitis Media What are the complications of OM? Describe the diagnosis and tx of Otitis Externa Differentiate from malignant otitis externa What is Ramsay Hunt Syndrome? How is it Tx? Describe your approach to sudden hearing loss How is it treated? Name 10 causes of epistaxis Describe your approach to tx epistaxis Anterior bleeds Posterior bleeds What is the differential diagnosis of neck masses? What is SIALOLITHIASIS? How is it tx? 

This episode covers Chapter 71 of Rosen’s Emergency Medicine. For such a small organ, the eye has A LOT of things to cover. Here we finish up in everything you need to know about that juicy ball of potential badness. List 10 causes of ↓ vision post blunt eye trauma What historical features are concerning for intra-ocular foreign body? List 4 options for treatment of corneal abrasions Describe the management of traumatic hyphema What causes the finding of a ‘second pupil’ post-trauma? Describe the physical findings of globe rupture and describe management List 5 indications for ophtho consultation for eyelid lacerations Describe diagnosis and treatment for orbital floor fractures: List 2 findings on X-ray of orbital floor fracture List indications for surgical repair of orbital floor fracture Describe the clinical findings of retrobulbar hemorrhage and the steps in performing lateral canthotomy List 3 complications of ocular trauma

This episode covers Chapter 70 of Rosen’s Emergency Medicine.   How are teeth traditionally numbered? Describe the classification and management of tooth fractures Describe the method for reducing a jaw dislocation? What is the usual direction of the dislocation? Explain Ludwig’s Angina and its management List 3 complications of maxillary (eg canine) tooth infection? Describe management of Dental Caries vs Periapical abscess Describe your approach to Acute Necrotising Ulcerative Gingivitis what is Vincent’s Angina? what is cancrum oris? Rapid Fire treatment for the following: Post root canal pain Cracked Tooth or Split root syndromes Maxillary Sinusitis Atypical Odontalgia Post extraction pain Neuropathic pain Temporomandibular Myofascial Pain Dysfunction Syndrome Pericoronitis Apthous Stomatitis WiseCracks Spot diagnosis

This episode covers Chapter 69 of Rosen’s Emergency Medicine.   Sign Post: 1. List six types of elder abuse? 2. List ten risk factors for elder abuse? 3. List ten questions to screen for elder abuse? 4. What are some indicators on the medical history and physical exam that may suggest ongoing elder abuse? 5. Discuss ethical and legal implications of elder abuse. Who needs to be reported?

  This episode covers Chapter 67 of Rosen’s Emergency Medicine. Its a heavy topic, but important to get right. What precautions should be taken prior to engaging in potential sexual abuse cases? What information can be useful in determining the location and likelihood of injury in sexual assault? What is the prevalence of mental illness in sexual assault patients?  Which populations are found to have a higher proportion of mental illness?  What effect does mental illness have on the severity of the attack? What factors make genital injury more likely to be observed?  Less likely? What are the risks of STI's after sexual assault? What are appropriate treatments for STI prophylaxis in cases of suspected sexual abuse/assault? What resources exist to help medical providers and any victims of sexual abuse? What differences should be considered with male victims of sexual assault?   ------------------------------ Thank-you to Dr. Sampsel for her assistance with this episode!