CanadiEM Podcasts: CRACKCast, ClerkCast, CarmsCast, First Year Diaries

This 123rd episode of CRACKCast covers Rosen’s 9th edition, Chapter 115, Selected Oncologic Emergencies. With an ever aging population, cancer incidence continues to rise. Therapies continue to prolong life often with high risks of side effects, and emergency physicians need to be equipped to treat complications of this treatment and importantly cancer morbidity itself.

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 urticaria Describe the typical features for each of the following: Measles Rubella Roseola Infantum Erythema Infectiosum Scarlet Fever Describe treatment of poison ivy Describe presentation and treatment of Pediculosis + Scabies List 10 causes of Erythema Nodosum List a 6 ddx for vesicular lesions List 4 lesions with a positive Nikolsky’s sign List 4 complications of HSV infection List 5 complications of Varicella + describe the management of an exposure during pregnancy List 5 complications of Zoster + differentiate between Ophthalmicus and Oticus What is the treatment of herpes zoster? Wisecracks List 5 causes of desquamating lesions List 5 palm and sole rashes List 10 maculopapular rashes List 1 low, medium and high potency topical steroid Identify the following rashes: erythema migrans, erythema marginatum, erythema multiforme, erythema nodosum, meningococcemia

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 Hypersensitivity Vasculitis List the diagnosis Criteria for HSP   WiseCracks What is the differential for SLE patient and Chest pain? Name and identify 2 pathognomonic clinical features for lupus When should Rheum be involved in the ED with a SLE patient? Spot Diagnosis: A 36 year old female stock trader present with what appears to be necrosis of the nose and ears… Spot diagnosis: 13 year old presents with abdo pain, polyarticular arthritis, foaming urine and the following rash… Rounds Pimper: List 10 side effects of chronic steroid use

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 bursitis in all cases of acute bursitis Aspirate bursa and evaluate the fluid Infectious bursitis is typically caused by Staph aureus  Non-septic bursitis differential diagnosis: Traumatic Rheumatologic Idiopathic Management of septic bursitis: Antibiotics NSAID's Rest Application of ice Elevation Prompt referral for follow-up +/- admission Core questions: What is the differential diagnosis for tendinopathy? What are common sites for tendinitis?  List 6 differential diagnoses for atraumatic non-septic bursitis List common causes for infected bursitis Wisecracks: Differentiate septic and inflammatory bursitis based on clinical exam and fluid aspirate results List 4 physical exam findings of impingement syndrome

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 evaluation and consultation with a mental health specialist Those patients who are deemed to be at low-risk of suicide may be discharged home to a safe and supportive environment, assuming they have no access to toxic medications or guns They should receive education and safety planning in the ED They should have early mental follow-up appointments   Core questions: Name 10 risk factors for suicide Name an additional 5 risk factors for adolescent suicide Describe the SAD PERSONS Scale Describe 4 potential targeted investigations for patients presenting to the ED with suicide Name 3 protective factors for against suicide

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 Music). Music provided by Vlog No Copyright Music. Video Link: https://youtu.be/AWv6Cr-RJaM Jorm - Broken (Vlog No Copyright Music). Music provided by Vlog No Copyright Music. Video Link: https://youtu.be/sl-o3ywNTV4 Skander Music - Back Home (Vlog No Copyright Music). Music promoted by Vlog No Copyright Music. Video Link: https://youtu.be/uwXmBL1kQT4 Pressure - Riot https://youtu.be/ELksuZkgQsQ Joakim Karud - Waves. Song/Free Download - https://youtu.be/xG8AWZSnFgI. Support Joakim Karud - http://smarturl.it/joakimkarud LAKEY INSPIRED - In My Dreams (Vlog No Copyright Music). Music provided by Vlog No Copyright Music. Video Link: https://youtu.be/PiKks_6yC8Q