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Podcast #45: No More NPO

Run Time: 3 minutes Author: Dr. Mark Kozlowski Educational Pearls: NPO or nil per os is a medical instruction meaning the patient should not have any food or drink orally. At Vanderbilt Medical Center, the nursing staff initiated a change in the NPO status from everyone has to be NPO to no one needs to be…

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Podcast #44: Myxedema Related Bradycardia

Run Time: 2 minutes Author: Dr. Susan Brion Educational Pearls: Myxedema is generally thought of as severe hypothyroidism. Presentation of myxedema is usually manifested with bradycardia, altered mental status, hypothermia, and swelling to the face. The patient’s labs will usually show hyponatremia, hypoglycemia, as well as some indication of primary or secondary hypothyroidism. Treatment is IV hydrocortisone…

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Podcast #43: Dental Injuries

Run Time: 7 minutes Author: Dr. Eric Miller Educational Pearls: There are three types of dental fractures or Ellis fractures. Ellis I is through the enamel, Ellis II is into the dentin, and Ellis III is into the nerve pulp of the tooth. For fractures, any bleeding should be controlled and the tooth should be completely…

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Podcast #42: Andexanet for Xarelto?!

Run Time: 2 minutes Author: Rachael Duncan, PharmD BCPS Educational Pearls: Eliquis and Xarelto are oral anticoagulants that inhibit the clotting cascade. Currently prothrombin complex concentrate or PCC can be used to reverse the effects of Xarelto or Eliquis by overpowering the inhibition of the clotting cascade. Andexanet is a medication currently in phase III trials that is…

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Podcast #41: CHF from Aortic Stenosis

Run Time: 5 minutes Author: Dr. Peter Bakes Educational Pearls: Common symptoms for congestive heart failure (CHF) are dyspnea, lower extremity edema, and chest congestion. Right heart failure usually presents with JVD and pedal edema. Left heart failure usually presents with chest congestion with rales and rhonchi. A crescendo and decrescendo murmur on presentation indicates congestive…

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Podcast #40: Altitude Sickness

Run Time: 2 minutes Author: Dr. Brent Levy Educational Pearls: Altitude sickness occurs on a spectrum, usually starting over 5000 feet above sea level. The minor presentation, Acute Mountain Sickness, includes headache and flu-like illness. High Altitude Pulmonary Edema is the more severe presentation, which includes severe hypoxia and shortness of breath and upon evaluation. This…

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Podcast #39: Propranolol Overdose

Run Time: 4 minutes Author: Rachael Duncan, PharmD BCPS Educational Pearls: Propranolol overdose presents with bradycardia, hypotension, decreased activity, and decreased body temperature. Propranolol is a lipophilic beta-blocker. Appropriate reversal agents for overdose on propranolol are epinephrine, dopamine, glucagon, calcium, levophed, and an IV lipid sink to sequester the propranolol. In cardiogenic shock, the heart begins…

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Podcast #38: Diphtheria and March 18th

Run Time: 5 minutes Author: Dr. David Rosenberg Educational Pearls: There are two cases of diphtheria per year in the United States due to our ubiquitously provided vaccinations. Diphtheria presents with a grey, leather-like appearance in the back of the throat as well as a “seal-bark” cough. This is caused by a relatively weak bacteria called Corynebacterium…

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Podcast #37: Aortic Rupture

Run Time: 4 minutes Author: Dr. Jared Scott Educational Pearls: The number first most common reason for sudden death after a motor vehicle accident is head injury, the second is traumatic aortic rupture. Due to the increased pressure of blood in the aorta, a rupture leads to rapid exsanguination. The most common location for a traumatic aortic…

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Podcast #36: Pulmonary Embolism in Pregnancy

Run Time: 4 minutes Author: Dr. Nicholas Hatch Educational Pearls: Risk of DVT and PE does go up with pregnancy and increases in each trimester. 1 in 50,000 people develop blood clots in the first trimester with 1 in 10,000 people developing blood clots in the second trimester. The risk for PE or DVT in pregnancy is…

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