Crackcast & Physicians As Humans On Canadiem

Episode Overview:   List 10 causes of Thrombocytopenia List 6 causes of Thrombocytosis Describe the presentation and treatment of HIT, ITP and TTP Describe what causes an abnormal PT? What causes an abnormal PTT? Describe the deficiency and management of Hemophilia A, Hemophilia B, and vWD Describe the management of a major and minor bleed in hemophilia A List 4 items in cryoprecipitate List  adjunctive therapies in DIC   Wisecracks:   How do you differentiate coagulation disorders from platelet disorders? What is thrombocytopathy? What do INR and PTT test? What is DIC?    

This 121st episode of CRACKCast covers Rosen’s 9th edition, Chapter 112 and 113, Anemia, Polycythemia, and White Blood Cell Disorders. These blood disorders are numerous and this episode attempts to break their classification and approach down in a systematic manner.

This episode covers Chapter 110 of Rosen’s Emergency Medicine (9th Ed.), Dermatologic Presentations.  Episode Overview List five broad categories of rashes Describe the primary skin lesion types  a. Bonus: What are the secondary skin lesions (show notes only) List systemic diseases that present with cutaneous signs for each of the following locations: Generalized rash Head and neck Hands Legs Palms and Soles Describe the various presentations of tinea and their treatment List 8 RFs for candida infections Describe the stepwise management of diaper dermatitis Describe the distribution of Pityriasis rosea Describe the management of atopic dermatitis Describe the management of impetigo & folliculitis List 6 RFs of C.A.-MRSA and 4 oral Abx treatments Describe the presentation and management of Staph Scalded Skin andTSS List 10 causes of EM / SJS / TEN Describe presentation of EM + SJS/TEN. Differentiate between TEN and SJS List 6 broad categorical causes of urtica

Episode 119 of CRACKCast covers chapter 109 of Rosen's Emergency Medicine 9th edition. Its hard to go a couple hours in the ED without seeing allergy or that life-threatening anaphylaxis, so you need to be tres familiar with this entity!!!

This episode covers Ch 108 of Rosens (9th Ed.), SLE and the Vasculitides. These conditions can lead to some pretty varied ED presentations, so we need to know when to suspect lupus or vasculitis, and how to manage it.  Episode Overview: What the pathophysiology of lupus List diagnostic criteria for SLE List drugs that induce lupus Describe the clinical manifestations w/  Classic triad & Symptoms and signs by system in lupus List 3 drug regimens to treat SLE How does neonatal lupus present? What is antiphospholipid syndrome? What is the unusual laboratory feature seen with this condition? What is the pathophysiology of vasculitis? Large vessel vasculitis Medium vessel vasculitis Small vessel vasculitis Hypersensitivity vasculitis Subcutaneous vasculitis Give examples of: Compare the findings for vasculitis List 5 criteria for dx of temporal arteritis + 2 associated features Describe the features of Behcet’s Disease List 10 causes of Erythema Nodosum Compare Buerger’s, Serum sickness and Hypersensitivit

This episode covers Chapter 107 of Rosen’s Emergency Medicine (9th Ed.), Tendinopathy and Bursitis.  Episode Overview: Mechanical overload and repetitive micro-trauma are the key underlying mechanisms of tendinopathy Most patients present with progressively worsening pain after work or sports-related activities that are repetitive in nature Tendinopathy can also be associated with non-mechanical causes such as: Systemic manifestations of disease Use of fluoroquinolones Infectious etiologies  Most patients with tendinopathies can be treated with conservative measures, such as: Protection Relative rest Application of ice Elevation Medications Overuse syndromes take at least 6-12 weeks to heal Patients need optimal loading and referral for physiotherapy or sports medicine therapy Urgent imaging of tendinopathy in the ED is rarely useful Clinicians may elect to use bedside ultrasound to evaluate for other diagnoses Operative treatment of tendinopathy is required in select cases Consider infectious bu

This episode of CRACKCast covers Rosen’s Ch 106, Arthritis. When a patient rolls in with an active joint, we need to know how to rule out those can't-miss diagnoses.

This episode covers Chapter 105 of Rosen’s Emergency Medicine (9th Ed.), Suicide.  Episode Overview: Suicide is a common but preventable cause of death Suicide is usually triggered by treatable or reversible short-term crises Most attempted suicide survivors are grateful to be alive Suicide risk changes over time; estimations of imminent risk are NOT evidence-based Routine screening labs provide little value to most ED patients with self-harm behaviours Evaluations should be targeted to signs or symptoms of disease on presentation Any ED visit for suicidal thoughts or behaviours represents a crisis and a teachable moment With your approach, it is important to be supportive, empathetic, and patient-centred Have a collaborative plan that integrates the input from collateral sources When caring for suicidal patients, use precautions: Sitters Physical/chemical restraints Involuntary admission forms Brief and focused risk assessment of patients in the ED can identify persons in need of further comprehensive

In the fourth episode of the Physicians as Humans project, I speak with Dr. Kevin Dueck, a family medicine resident at McMaster, about his decision to take parental leave during residency. Also check out his blog https://abootmedicine.wordpress.com/! This is an ongoing project, so if you or anyone you know have a story about managing personal struggles while in medicine, please contact velmurug@ualberta.ca. If you are unfamiliar with the project, please read this post for more information on the origin of this podcast series. The CanadiEM podcast can be added to your podcast application from the iTunes store or by entering the podcast RSS feed. If you would prefer to download it, click here. It can also be streamed above. Thanks for listening and please refer your colleagues! Music for Episode 04 (All songs have been modified for the project) ambient by strange day. Music provided by Music for Creators under a Creative Commons Attribution 3.0 Unported— CC BY 3.0 license. NOWË - Burning (Vlog No Copyright Mus

This episode of CRACKCast covers Rosen' 9th edition, Chapter 104, Factitious Disorders and Malingering. Episode Overview Two categories of psychiatric illness are covered in this episode Factitious Disorder Malingering Individuals suffering from factitious disorders fabricate symptoms of illness to fulfill the sick role (primary gain) Individuals suffering from malingering fabricate symptoms of illness to obtain something (secondary gain) Despite the fact that we may suspect either factitious disorder or malingering, we must strive to objectively assess the patient for concrete evidence of disease If no objective evidence of disease exists in a patient, do not investigate with needless and/or harmful diagnostic modalities Refer back to their primary care physician If you are suspecting factitious disorder by proxy, the safety of your patient should always be your first priority  Core Questions What is a factitious disorder and what is malingering? List the DSM-5 diagnostic criteria for factitious dis

This 113th episode of CRACKCast covers Rosen’s 9th edition, Chapter 103, Somatoform Disorders. The diagnosis of SSD is made when there are persistent and clinically significant physical complaints that are accompanied by excessive and disproportionate health-related thoughts, feelings, and behaviours regarding these symptoms. Recent publications refer to “medically unexplained physical or somatic symptoms,” rather than somatization.

This episode covers Chapter 102 of Rosen’s Emergency Medicine (9th Ed.), Anxiety Disorders.  Episode Overview Patients who present with predominant symptoms of anxiety may be suffering from medical disorders (think cardiac, resp, endocrine, neurologic), medication effects, or substance abuse or withdrawal. Anxiety may accompany the onset of serious medical disease, cause significant metabolic demands, and stress a marginally compensated organ system. Anxiety caused by physical illness is usually suggested by the patient’s physical findings but may require testing to further delineate the cause. Oral, intravenous, or intramuscular medication may be necessary for patients who are a significant threat to themselves or others and for anxious patients with significant medical illness. Limited benzodiazepine therapy may be helpful for select patients. SSRI’s are the go-to long term therapy. Core questions:   List 5 predictors of anxiety caused by an underlying medical issue (box) List 10 organic diseases that

This episode of CRACKCast covers Rosen’s Chapter 101 (9th Ed.), mood disorders. The podcast will focus on the diagnosis and management of common mood disturbances. Episode Overview Patients with apparent mood disorders should be evaluated for medical disorders, medication effects, substance abuse or withdrawal because these conditions can mimic both depression and mania. Mood disorders should be suspected in patients with multiple, vague, nonspecific complaints and in patients who are frequent, heavy users of medical care. The differentiation of depression and dementia in elders can be difficult, but is important because depression often responds dramatically to treatment. Patients with mood disorders should be assessed for their suicide potential. Core questions: List the 3 neurotransmitters implicated in depression List the DSM V criteria for Major Depressive Episode (box) Define Seasonal Affective disorder, Dysthymic Disorder and Cyclothymic disorder Define Bipolar I and Bipolar II L

This episode covers chapter 110 of Rosen's emergency medicine (100 in the 9th edition). Confused about thought disorders? We can set you thinking straight!

This episode of CRACKCast covers Rosen’s Chapter 109, CNS Infections. This chapter covers a differential diagnosis for CNS infections, including necessary workup and approaches to treatment.

Are you confused by the NMJ? Good.... because we were too. This episode of CRACKCast covers Rosen’s Chapter 108, Neuromuscular Disorders. These disorders have a wide range of presentations and etiologies.

This episode of CRACKCast covers Rosen’s Chapter 107, Peripheral Nerve Disorders. These disorders have a wide range of presentations and etiologies. This chapter includes a comprehensive classification system to help in the ED in recognizing the various disorders.

This episode covers chapter 106 of Rosen's Emergency Medicine. Check out chapter 96 in the pretty new 9th edition. If you don't have it yet... you should. Ever wondered about how to get the spinal syndrome's straight? We've got that covered, and more of course!    

This episode of CRACKCast covers Rosen’s Chapter 105, Brain and Cranial Nerve Disorders. These can be the weird and wonderful in the ED, but subtle hints can clue us in that further investigation is needed for our patients. Having a high suspicion for these diagnoses can help you make an appropriate care plan and follow up for patients with neurological disease.

This episode covers Chapter 104 (or 94 in the 9th Edition) of Rosen's Emergency Medicine. If you can't get delirium versus dementia straight in your head, then this is the podcast for you! Core questions: List the four key diagnostic criteria for delirium List six strong predisposing or precipitating factors for delirium List 15 causes of delirium Describe how to use a screening tool for delirium: MMSE List 3 potential medications used for chemical restraint List 2 potential side effects of Haldol administration Compare delirium with dementia List important diagnostic studies for the workup of delirium List four diagnostic criteria for dementia List 10 specific causes of reversible dementia List 10 causes of non-reversible dementia Wisecracks: Explain how you differentiate between psychosis, delirium and dementia. How does Aricept work? Describe the pathophysiology of Alzheimer’s dz and list RFs for its development What is the triad of normal pressure hydrocephalus?