Q263 - Cholecystitis vs Cholangitis

There is one key clinical finding that will help you easily distinguish between the two.

Q262 - Pediatric handlebar injuries

The key here is 'which organ is disproportionally affected?". This can have an insidious presentation unless you know what to look for.

Q261- Bruises on a pediatric patient

Which ones are red flags?

Q260- Sulfonylurea ingestion

Do you know what to do with a child who swallows this?

Q259- Phosphate: a sneaky electrolyte

There's a disturbance in the phosphate (lol)

Q258 - Testicular Torsion diagnosis

Do you know the key clinical presentations to look out for? More importantly, what's the next best step?

Q257 - Chagas Disease, do you know the key chro...

You're not going to be asked about acute treatment, but you certainly need to know the key epi and the chronic findings.

Q256- Knee dislocation? Not so fast on that dis...

This is the perfect board question- listen twice to understand this pearl!

Q255 - Fat Embolism Syndrome clinical findings

Do you know the 4 main end organ findings? You need to be able to rapidly diagnosis this syndrome.

Q254- Knee Dislocations are scary

Reduce 'em and discharge? Not so fast!

Q253- Overdose with GCS 5, but full recovery

Can you guess this classic, rare illicit substance?

Q252- Puncture wounds in water? Beware!

There's one nasty bug you can never miss!

Q251 - Labs and vital sign changes in pregnancy

Do you know how to interpret changing lab values and vital signs in your patients with pregnancy?

Q250 - Septic Arthritis

There are 3 main pathogens you need to know for tests and for life.

Q249 - Vancomycin flushing syndrome

Do you know what causes this reaction? It's the most common adverse reaction to vancomycin.

Q248- Swallowed a truckload of cocaine?

How to manage this patient with bags of cocaine in their intestines

Q247- Body packers in the ED

Body packing is a sad, but fascinating topic in the ED

Q246- Challenging Tox board question

Sadly, the answer is different in clinical practice vs boards. But you must know it!

Q245- Anticholinergic Toxidrome

You know it... but what happens first?

Q244- Septic shock and AKI

Which vasopressor is your go-to? You may be surprised.

Q243- Deep, scary T waves

This one pathology on EKG will change what you order next!

Q242 - How are you going to treat this hyperkal...

You certainly aren't going to be doing what you usually do....

Q241 - Tumor Lysis and lab values

This is one of the easiest questions to get right on a test. Do you know the 4 key lab values they will always ask you about?

Q240 - Metastatic spinal cord compression treat...

Knowing the right order for treatment is critical for this pathology.

Q239- Pediatric SVT

Its easier than you think, so let's just tweak your maneuvers!

Q238- Neonatal RSI

Bring a fresh pair of undergarments and make sure you do this critical step right!

Q237- First time seizure

There is ONE thing you MUST do!

Q236- Bradycardia with a facial fracture?

You need to react quickly with this child with an orbital fracture

Q235 - Metastatic spinal cord compression

So yes, the answer is get a MRI, but do you know the studies to do if MRI is not available? What about the study that has similar sensitivity?

Q234- When do you consult for orbital fractures?

Hint: it actually should not be that common...

Q233 - Pregnancy, nausea, vomiting

No, the first line treatment for this is NOT your go to antiemetic for every other patient in your ER!

Q232 - Primate bite management

So you have a patient who was bitten by a monkey. Do you know the pathogen you should be worried about? Do you know how to treat?!

Q231- MVC risk factors

Who are you concerned the most about?

Q230- Orbital blowout fractures

Pain and swelling to the orbit, what is your next move?

Q229- Epidural Spinal abscesses

You got back pain and fever, what's your next move?

Q228- Rib fractures

Multiple rib fractures, hypoxic, what's your move?

Q227- VP Shunts in pediatric patients

Do you know ALL the complications of pediatric VP shunts? Well then, we have a lot to talk about.

Q226- Alcohol and ketoacidosis

What's your next move?

Q225 - Posterior fat pad

Lateral view elbow, posterior fat pad seen - what's the diagnosis AND management?

Q224 - flexor tenosynovitis

Do you know the 4 kanaval signs? Sure, but do you know which one presents FIRST and which one presents LAST?

Q223 - Pregnancy and minor trauma

There are two specific things you need to do that can be life changing for not only the mother but the fetus. Do you know what they are?

Q222- Cardioversion in pregnancy

Do you know which drugs are safe... or which ones do you avoid?

Q221- Intubating in salicylate overdose

Want to kill your patient? Don't do this.

Q220- Treating salicylate poisoning

There is only one antidote, and its time to stop overthinking this

Q219 - Clonidine toxicity

Do you know the clonidine "antidote" and how and when to dose?

Q218 - Hypoglycemia "antidote" for this diabete...

Okay, so this might be a difficult question for you. Either way, we make sure you know how to treat Sulfonylureas toxicity.

Q217 - This antibiotic can cause seizures, do y...

This is a critical antibiotic to know. It doesn't take much of it to cause seizures. The antidote is critical to remember.

Q216- Aspirin overdose

Can you recognize this tox case early enough?

Q215- Management of RPAs

Can you name the correct antibiotics for RPA tx?

Q214- RPAs and the Danger Zone

Kenny Loggins knows it, but could you catch this scary infection?

Q213- Pregnancy and RhoGAM

Do you know WHEN to give it? Like, specifically when...

Q212 - Pregnancy and wheezing

Asthma is the most common chronic respiratory condition in pregnancy - which means you need to know this for boards but more importantly for life.

Q211- Stercoral colitis...wait what is it?

No its not just constipation.

Q210 - Postpartum pelvic pain, fever

Labs, imaging and every "objective" measure can be normal, but after you listen to this, you'll know how to make this diagnosis.

Q209 - Facial swelling worse with eating

The title alone should tell you what we're going to discuss. If you don't make the connection, you will after you're done listening to this episode!

Q208- Managing (and pronouncing) Sialolithiasis

There are some critical things you must know

Q207- Do you know how to manage Hemophilia A?

Its not as common as Warfarin reversal, but you need to know it!

Q206- Hepatitis B post-exposure, but for WHO?

Which healthcare workers need post-exposure vaccination?

Q205- To tap the knee, or not tap the knee?

I'll give you a hint- tap it!

Q204 - Fundoscopic exam findings, do you know t...

"Blood and thunder", cherry red spots, fluffy white perivascular lesions, out of focus retina -- do you know what each of these are associated with?

Q203- Bites, Stings, and Ouchies

Let's rapidly review these classic envenomations for the boards!

Q202- Thyroid Storm and medications

Do you know the correct order? You should.

Q201- Exam findings for Appendicitis

TL;DR- they aren't that accurate.

Q200 - Sudden onset, painless vision loss

Sudden onset and painless vision loss. Do you know the "buzz words"? What about the first IMMEDIATE thing you should be doing to this patient to help restore their vision? Even before ophthalmology comes to see them??

Q199 - How are you going to manage severe eye p...

The patient has injected conjunctiva, a fixed midpoint pupil, severe eye pain. You better know the medications that need to be administered as well as definitive management of this.

Q198- How to not miss Serotonin Syndrome

Key difference from NMS!

Q197- Don't get fooled by Dantrolene!

NMS treatment isn't just about dantrolene

Q196 - Headache, hypertensive, with a fixed mid...

What is the next BEST step? Imaging? IV labetalol? ocular eval? migraine cocktail? You should know the diagnosis simply from our title to this pod, but what's the next best step?

Q195- Can you nail the dx of NMS?

Let's quickly cover Neuroleptic Malignant Syndrome!

Q194- Hip dislocations in <5 minutes

Let's knock out some easy board pearls!

Q193 - Elevated lithium levels

Do you know how to treat elevated lithium levels. And what will make you decide on your treatment choices?

Q192 - Tumor Lysis Syndrome, all you need to know!

There are 3 key ways this question is asked on exams.

Q191- Most common cause of SBP?

Plus let's talk how to diagnose it!

Q190 - Abdominal pain but afebrile, no leukocyt...

Objective measures are all reassuring, so what are you doing to do?

Q189 - Are you giving this patient tPA or stero...

So based on this presentation we give you, are you going to A. order neuroimaging B. do a TIA workup? C. give tPA immediately or D. give steroids?

Q188 - Can you name the pathogen for this pneum...

Review of pediatric pneumonia pathogens, but this particular one is a dreaded one...

Q187- SBP presentations- not so obvious?

Do you transfuse before tapping?

Q186- Proper neuroimaging in IIH

Sure it sounds easy, but can avoid this trap?

Q185- Would you catch this pt with IIH?

The presentation is classic, but do you really know the details?

Q184- Pitfalls of treating Pediatric UTIs

Can you name the correct, go-to antibiotic?

Q183- Interpreting Pediatric Urinalyses

Let's stop misinterpreting UA results

Q182- Do you know risk factors and presentation...

UTIs are common in pediatrics, let's stop being bad at diagnosing them...

Q181 - Can you name the correct cofactor for th...

Let's finally put an end to our talk on toxic alcohols.

Q180 - Influenza and hospitalized patients

Do you know what the CDC says about influenza and hospitalized patients?

Q179- Do you know the BEST method to treat toxi...

Fomepizole vs Ethanol? Its not what you think...

Q178 - Remember influenza? It's finally back!

CDC makes it clear when you need antivirals, do you know what they are? (and it's not just that 48 hour thing...)

Q177- Do you know the most common electrolyte a...

Osmolal gap, anion gap, you getting the picture? If not, listen to this and we got you.

Q176- Hyponatremia? Do you really know when to ...

Do you know the right type of fluid / concentrations to give and when?

Q175 - Common cause of shock in trauma patients

Neurogenic vs hemorrhagic and a host of other key pearls you need to know

Q174 - Hypothermia and the key physiologic chan...

Is it oliguria or diuresis? hypoglycemia or hyperglycemia? metabolic acidosis or alkalosis? and more...

Q173 - Basic principles of caustic ingestions

Treatment: "nothing" or EGD or admit and observe? We tell you the key dispositions.

Q172 - The fastest method to rewarm a patient i...

Tricky question, but so easy to get it right on the exam. Good to know for real life as we talk about the key temperature when deciding between External vs Internal rewarming.

Q171 - Hypothermia and EKG changes, they love a...

Everyone loves asking about EKG changes for hypothermia patients. The great thing is there are only 3 main changes you need to know -- we review them quickly for you.

Q170- Caustic ingestions and the biggest predictor

What are the key imaging modalities you can use, and what presentation should worry you?

Q169- Tylenol overdose stages

Do you know them? Are you sure you won't confuse them with iron overdose?

Q168- Variceal bleeding: best medication ever?

Its not what you think...

Q167- Flail chest FIRST step in management

...we're pretty sure you'll get this question wrong, but promise it'll be seared into your memory.

Q166- The Shock Index in trauma patients

This might catch hemorrhage shock faster than HR or BP!

Q165- Dark, dusky bowel in elderly? One can't m...

Never underestimate Mesenteric Ischemia

Q164- How to have a zero miss rate for AAA

Pearls to avoid a AAA miss...

Q163- Iron Toxicity stages

It stinks, but you really need to know the order of these!

Q162- Iron Overdose Management

Hint: ipecac is always the wrong answer (hehe)

Q161 - What causes the 3 D's?

Hint: A specific vaccination has dramatically reduced it's incidence....

Q160- The 3 D's: Drooling, Dysphagia, Distress ...

Important to know for test questions, but "more importantly", life.

Q159- Priapism Treatment pearls

Are you certain you can treat priapism correctly?

Q158- Priapism and its causes

Do you know the most common cause?

Q157 - Myasthenia Gravis, pearls and sneaky pre...

MG and it's most common presentation? Mainstays of treatment? And a sneaky presentation that could save a life....

Q156- When sniffing kills

Hold your breath when you see these patients crashing!

Q155- Can you manage "huffing" overdoses?

It's straightforward, but here are the key disposition pearls

Q154- SCAPE Treatment- do you really know it?

Are you REALLY sure what to do first?

Q153 - Do you know to treat this swollen joint?...

Swollen joints and their treatment. You need to know the causative agent here. It's not obvious and kinda sneaky. Did we just give this answer away?

Q152 - HA management and 2 key treatments

No, the correct answer choice is not "migraine cocktail". Also, we equate using the phrase "migraine cocktail" with saying "double pneumonia". Come on now.

Q151 - Do you know how to stop this seizure?

So you think you do, this seems pretty straight forward. But there is only one agent in this answer choice that is overwhelmingly the correct answer choice.

Q150 - Pre-E criteria, the "subtle" things

Yes, you know to give IV magnesium. But do you know what to do when there isn't proteinuria present? What is the diagnostic criteria then?

Q149- Intubating asthmatics

Do you know which agents to use?

Q148- Asthma vent settings

Do you know how to keep these sick patients alive?

Q147 - Acetaminophen toxicity, all the pearls y...

You might think this is obvious, just refer to "the nomogram". But -- when exactly should you refer to it? When should you NOT refer to it? When can you give NAC without referring to it?

Q146 - Caustic agents and what to do and what N...

Gotta remember Coagulative necrosis vs liquefactive necrosis. We review management of caustic agents. We also review things you should NOT do.

Q145 - LVADS, most common cause of failure? part 2

Part 2 of LVADS. We review the most common cause of failure, the most common cause of hypotension, sites of infection, immediate ED interventions, and more.

Q144 - LVADS rapid pearls part 1

LVADS - yes, annoying, but a limited number of ways you can be tested on them. We rapidly go through some pearls in this part 1

Q143- Which physical exam finding is most assoc...

Do you fall into this trap?

Q142- Uremic bleeding- sounds awful?

But if you have this drug at your disposal, it might change the game!

Q141- N-acetylcysteine and anaphylaxis

Would you restart NAC after anaphylaxis?? Get ready to be floored.

Q140- HARD Signs of extremity trauma!

Would you send this patient to the operating room or CTA?

Q139 - Nosebleeds and those artery sources

*sigh* yes, you just need to know these. Good news: easy to remember, easy to get right on the test, and great pearls to bring up during work!

Q138 - Literally all the ways you'll be tested ...

They love asking about Ludwig, and there is a reason why. There are some critical aspects you need to identify quickly in order to save a life.

Q137 - Do you know when to give Prostaglandins?

Also, do you know these critical adverse effects?

Q136- What is actually evidence-based for pancr...

There are a lot of myths when it comes to pancreatitis, let's clear it up.

Q135 - Symptomatic yet stable atrial fibrillati...

Everyone knows what to do with the atrial fibrillation patient who is unstable. However, what are you going to do with the stable yet symptomatic patient with A-fib? There are some key pearls and specific cutoffs you just need to know.

Q134- Do you know how to manage a Tet Spell?

Forget the weird order of medications, let's simplify this!

Q133- Swing like a butterfly, sting like a... b...

This answer highlights how to not miss a bad fracture outcome!

Q132 - When things go "wrong" after you place t...

Not only do you need to be able to rapidly recognize this condition, but you should know key things that can predispose your patients to it and how you can prevent it from happening in the first place.

Q131 - Blunt abdominal wall trauma, organs most...

Do you know the order of organ injuries from most to least likely? We get into this and then deliver some key pearls you'll love.

Q130- Do you really know Erythema Multiforme?

This classic rash can cause a headache if you forget its causes!

Q129- Let's do a rundown of Epstein Barr Virus

We're sure a lot of you will pick one answer, so that's why we're doing this podcast.

Q 128 - Yes, postobstructive diuresis can resul...

Post-obstructive diuresis is something you need to know because it can result in significant morbidity and mortality if not diagnosed appropriately. Do you know the numbers to make this diagnosis?

Q127- Can you tell the difference between these...

Its a weird word to describe the rash, but boards love to use it!

Q126- Do you know what to use for BP control in...

Seriously, you were probably taught wrong in medical school so let's clear it up.

Q125- Wet, wobbly, and wacky? Try again!

This question will change the way you think about NPH (normal pressure hydrocephalus)!

Q 124 - Urinary Retention, do you know the most...

A review of a commonly seen acute condition in the ED - urinary retention! You need to know the key causes!

Q123 - Do you know when to order a CT pyelography?

You may have never ordered this test, but you better know it for trauma patients!

Q122 - What does asymptomatic HTN mean?

This answer choice might differ from what you've seen in practice, but its right!

Q121 - Eye bacteria in contact lens, you might ...

You might be thinking this is obvious, I know this, I know the bacteria I'm treating. But do you? Do you?

Q120 - Eye pain in trauma, act fast.

Eye pain in trauma is something that get really bad, really fast. There are two treatment modalities you need to know. One of those we know you know, the other...maybe not?

Q119- Can you remember why TCAs are so deadly?

You may have forgotten this from med school, but we promise you'll never forget it after this episode!

Q118- Do you know the first sign of Ach toxicity?

This may not be that obvious but in combination with one other symptom, you cannot miss anticholinergic toxicity!

Q117 - You'd be surprised at what is FDA approv...

One of our answer choices here might surprise you. We use it off label for every time of bleeding, but it's actually FDA approved for this.

Q116- Would you catch this case of botulism?

Botulism is a scary little anaerobe, gram positive rod. It inhibits the release of Ach at motor junctions, leading to a flaccid motor paralysis...

Q115 - Unstable vaginal bleeding, do you know t...

There is one specific treatment that is considered first line for active vaginal bleeding in unstable patients.....(FDA approved)

Q114- Can you properly treat Bell's palsy?

Bells palsy = Unilateral facial nerve paralysis from lower motor neuron involvement of Cranial Nerve VII...

Q113- Do you know how to manage acute hepatic e...

We talked earlier this week about defining acute liver failure. This question delivers a similar aspect of treating end stage liver disease...

Q112 - Dogmentin

Do you know about "dogmentin"? But what exactly are you treating and what about that dreaded Penicillin allergy?

Q111- Do you know how to recognize Acute Liver ...

Acute liver failure is some type of severe liver injury that leads to near-immediate failure of the synthetic function of the liver, with a high risk of permanent liver infarction and mortality...

Q110 - RUQ, don't be fooled by the triad

It's all about the triad right? The pentad? nope.

Q109- Do you know how to not miss septic arthri...

Classically monoarticular, large joints are the most common sites, and the knee is involved >50% of cases....

Q108 - What has the best sensitivity for the RUQ?

So you're telling me the RUQ U/S might not be the best test? You need to know your tests and their limitations.

Q107- HUS- what is the best treatment for best ...

Hemolytic uremic syndrome (HUS) is a clinical syndrome characterized by an acute kidney injury with associated microangiopathic hemolytic anemia and thrombocytopenia...

Q106- Subungual hematomas, leave the nail?

Subungual hematoma is blood accumulating under the fingernail or toenail from trauma. Typically its from a blow to the distal phalanx...

Q105 - Ascending paralysis, do you know the nex...

Ascending paralysis is always terrifying, especially in the pediatric population. We go through the differential and ask a specific board type question that you might not get right.

Q104- Can you find Digoxin overdose on the EKG?

Digoxin causes numerous changes to cardiac electrophysiology....

Q103 - Syncope, what's high risk?

You need to know high risk vs low risk syncope. What gets admitted and what can be discharged? Do risk stratification tools even work?

Q102 Scary seconds- which BRUEs do you admit?

A “brief resolved unexplained event” or BRUE, is not a specific diagnosis, but rather a diverse group of patients with various pathology...

Q101 Syncope eval - don't shotgun please

Syncope is one of the most common presentations to the ED. We go through high yield tests that actually help, and talk about one in particular you should really avoid ordering in most patients.

Q100- Digoxin mechanism of action, what's altered?

In myocytes, the intracellular influx of calcium is necessary for muscle contraction. Cardiac glycosides reversibly inhibit the membrane Na-K ATPase...

Q99 Nephrolithiasis diagnosis, do you know what...

Kidney stones are common causes of abdominal pain, with total prevalence in the US 5%, making it quite a routine ED diagnosis...

Q98 - 90% mortality from this Trach complication

You have to know when this happens and how to manage it rapidly in the ER. The mortality is 90% but the temporizing measures work 85% of the time.

Q97 Lyme disease prophylaxis - when and what?

We get into the weeds about Lyme disease treatment when it comes to prophylaxis

Q96 Mesenteric Ischemia - Everything you need t...

This is everything you need to know on mesenteric ischemia in less than 4 minutes. Plus we tell you how they will set it up for you on tests!

Q95 High Yield PE pearls

We tell you 3 critical PE pearls you just need to know!

Q94 Lemierre's Syndrome, don't miss this rare d...

This patient has a concerning Lemierre Syndrome, otherwise known as septic thrombophlebitis of the internal jugular vein...

Q93 - PE & common ECG change (not what you thin...

You think you know this, but this question will probably trip you up!

Q92 Giant Cell Arteritis, how can you stop visi...

GCA is a devastating, uncommon condition. Most common systemic vasculitis, but thankfully one key helpful pearl is that it never occurs in patients <50 years old.

Q91 - Differentiation between CCB and BB toxici...

Q90 Cranial Dissection, don't miss this devasta...

Q89 CCB overdose

First and most obvious -- evaluate the patient’s ABCs. Next -- supportive agents, such as fluids and vasopressors are indicated due to the patient’s hemodynamic instability...

Q88 Subarachnoid hemorrhage

Q87 Drowning ED Tx Pearls

Q86 Priapism Pearls

Q85 Ectopic pregnancy risk factors

Q84 Cocaine & chest pain

Q83 NMS vs SS key difference

Q82 Excited Delirium management

Q81 Cocaine

Q80 Lightning strikes

Q79 Compartment Syndrome nerve distribution

Q78 TRALI vs TACO

Q77 Compartment Syndrome regions

Q76 Epistaxis Treatment

Q75 Guillain-Barré Presentation

Q74 Imaging in intussusception

Q73 Hyphema management

Q72 Fluids in Rhabdomyolysis

Q71 Transfusion Reaction Types

Q70 Traumatic Aortic Injury

Q69 Preeclampsia

Q68 Electrolyte EKG findings

Q67 Aortic Dissection risks and exam

Q66 Hyperkalemia

Q65 Hydrofluoric acid

Q64 HIV infections

Q60 Meningitis

Q59 Mesenteric ischemia

Q51 Ectopic pregnancy

Q50 Pelvic fractures

Q49 MAO inhibitors

Q48 HHS management

Q47 Hypercalcemia

Q46 HIV Pneumonia

Q45 Meckel's Diverticulum

Q37 EKG patterns, HOCM

Q36 LVAD complications

Q35 Acute Mountain Sickness

Q34 Spontaneous Pneumothorax

Q33 Pediatric Pneumonia

Q32 Swallowed FBs

Q31 Hepatitis B exposure

Q30 Tenosynovitis

Q29 High pressure injection

Q28 Hyphemas

Q27 Status Epilepticus medications

Q26 Submersion Injury

Q25 TCA Overdose

Q24 Traveler's Diarrhea

Q23 Necrotizing Fasciitis

Q22 Pregnant Trauma

Q21 HUS

Question 20

Q19 Pericarditis

Q18 FAST exam

Q17 Blast injuries

Q16 Meningitis Bugs and Drugs

Q15 Dengue Fever

Q14 DKA and HHS

Q13 Aortic Dissection stats

Q12 HOCM murmur

Q11 Spider bite

Q10 Whooping Cough

Q9 Concussion care

Q8 Anaphylaxis Epinephrine

Q7 Identifying stroke lesions

Q6 Nitrates

Q5 Esophageal Varices management

Q4 Facial Fractures and Antibiotics

Q3 CroFab and snake bites

Q2 Brain natriuretic peptide

Q1 DVT Anticoagulation

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