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

This episode covers chapter 84 of Rosen's Emergency Medicine. All the little nuggets of medical goodness you wanted to know about hypertension related emergencies. Define the three classes of hypertension relevant to emergency medicine practice List 10 possible etiologies for hypertension. What is the pathophysiology of target-organ damage? How does hypertensive encephalopathy occur? List 6 hypertensive emergencies; their management goals; the optimal agents for BP control and any relevant caveats List five intravenous antihypertensive medications and their mechanism of action. Describe the ER management of poorly controlled HTN Wisecracks: What are the management targets / indications for treatment in the following pts: 57 yo male with ICH and no signs of ↑ ICP. 39 yo female with SAH in the ED. 22 yo female with eclampsia. 66 yo female with ACS. 57 yo male with aortic dissection. 62 yo female with ICH, ↓ GCS, shift on CT scan.  

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 aortic stenosis?Outline the ED management for a pt with critical aortic stenosis with CHF and hypotension. List 5 complications of prosthetic valves.  WiseCracks: Describe Janeway lesions Osler nodes Splinter hemorrhages Roth Spots What are the HACEK organisms, and what is their significance in pts with IE? Brief run down of all valvular disease - in one or two lines.

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 HCM List 5 RFs for sudden death in HCM A pt with known hypertrophic cardiomyopathy presents to the ED with acute cardiogenic pulmonary edema causing mild hypoxia.  What is the general approach to management in the ED?  Explain your choices. List four causes of dilated cardiomyopathy. Describe ECG findings of dilated cardiomyopathy List 5 RFs for developing a dilated cardiomyopathy In what time frame would one expect peripartum DCM? List 5 causes of restrictive cardiomyopathy List 8 common pathogens responsible for myocarditis, and 3 non-infectious causes of myocarditis Describe the stages of viral myocarditis and the management at each stage     Wisecracks:   What are some functions of the pericardium? What are Chagas Disease and Trichinosis, list bizz-buzz features for each? What are the expected cardiac findings in Lyme disease and how is it treated? How does sarcoid affect the heart? Amyloidosis?  

Dive into the fascinating world of heart failure! Explore the critical concepts of cardiac index, preload, and afterload, and uncover key disease processes that lead to this condition. Learn about the various classifications of heart failure and the significance of the NYHA and Killip systems. Gain insights into essential diagnostic findings and the role of BNP in prognosis. Plus, discover tailored treatment strategies for managing acute and chronic heart failure, including the innovative use of NIPPV and effective medications.

Dive into the fascinating world of implantable cardiac devices, discussing their roles, complications, and indications for use. The complexities of pacemakers are explored, including malfunction types and specific challenges like lead disconnection. Learn about the critical five-letter nomenclature, the mysteries of pacemaker syndrome, and how magnets can affect these devices. Additionally, navigate the intricacies of managing Left Ventricular Assist Devices in emergency settings, ensuring you’re equipped for diverse cardiac scenarios.

Dive into the world of cardiac rhythms as the discussion unpacks ECG mysteries and the blood supply of the conduction system. Learn about the three mechanisms behind dysrhythmias and how conditions like AV nodal reentry tachycardia arise. The episode further breaks down antidysrhythmic drugs, their actions, and when to use digoxin. Explore various types of heart blocks, sick sinus syndrome, and intriguing concepts like Wolff-Parkinson-White syndrome, alongside essential management strategies for atrial fibrillation and tachycardias.

Dive into the world of acute coronary syndromes where experts break down critical criteria like Sgarbossa for diagnosing AMI and uncover the complexities of Takotsubo cardiomyopathy. Explore the kinetics of cardiac biomarkers like Troponins and learn the ins and outs of PCI versus thrombolytics. Discover the importance of timely interventions and the nuances of managing NSTEMI patients. Plus, gain insights on unique cases like cocaine-induced ACS and the role of cutting-edge tools such as the HEART score!

Dive into the world of Acute Coronary Syndromes with a focus on defining stable and unstable angina, as well as myocardial infarctions. Discover the critical pathophysiology of AMI and essential pre-hospital management strategies. Learn about population risk factors and their implications, while addressing the nuances of atypical presentations. The discussion includes early complications of myocardial infarction and how to manage them. Plus, uncover key ECG changes that could be lifesaving in emergency situations.

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 pneumothorax? How is it tx? How do you properly Secure a chest tube? Describe the seldinger technique for chest tube insertion What are the false positives for PTX on lung U/S?

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?