Episodes: Masonry

Podcast 533:  Hypoglycemia

Contributor: Dylan Luyten, MD Educational Pearls: Insulin related hypoglycemia can vary from a brief transient effect from short-acting forms (i.e. insulin lispro) to prolonged from long acting (i.e. insulin glargine), and will require different treatment and/or observation Of oral glycemic agents, sulfonylureas are a common culprit while metformin is rarely a cause Sulfonylureas also deserve...

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Podcast 533:  Hypoglycemia

Superior Vena Cava Syndrome

Superior Vena cava syndrome Chief Complaint: Facial Swelling HPI: Patient presents to the emergency department reporting several days of recurrent facial swelling. She states that when she wakes in the morning, starting 3 days ago, she has significant facial swelling. Yesterday there was some extension of the swelling down to her bilateral upper extremities and...

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Superior Vena Cava Syndrome

Podcast 532:  SVC Syndrome

Contributor: Jared Scott, MD Educational Pearls: Superior vena cava (SVC) syndrome is caused by physical compression of the SVC and can present with facial swelling, upper extremity swelling, flushing, and parasthesias Common causes of SVC syndrome include lung cancer, lymphoma, and thymoma Keep SVC syndrome on the differential for all patients with facial or upper...

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Podcast 532:  SVC Syndrome

Podcast 531:  Migraine Cocktail 

Contributor: Don Stader, MD Educational Pearls: The classic migraine cocktail includes: Reglan (or other dopamine antagonist), Benadryl, Toradol, Decadron, and IV fluids.  The most effective agent in the cocktail is a dopaminergic agent  Routine IV fluids have not shown efficacy  There is no evidence for pre-treatment of akathisia with diphenhydramine (Benadryl) Decadron reduces rebound headache ...

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Podcast 531:  Migraine Cocktail 

Podcast 530: Anion Gap Acidosis + Metformin Toxicity

Contributor: Don Stader, MD Educational Pearls: The common causes of anion gap metabolic acidosis include (MUDPILES) Metformin, Methanol  Uremia  DKA Paraldehyde  INH/Iron  Lactate Ethylene Glycol  Salicylate  Metformin is a very common drug used to treat type 2 diabetes, however in the right setting, it can cause a profound lactic acidosis. There is a very high...

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Podcast 530: Anion Gap Acidosis + Metformin Toxicity

Podcast 529: Hemophilia

Contributor: Aaron Lessen, MD Educational Pearls: Hemophilia is characterized by bleeding (A /B) A is is 8, B (chrstmas, 9)  Hemophilia refers to a group of bleeding disorders caused by a deficiency in a certain clotting factor. The two most common are hemophilia A (caused by a lack of factor VIII), and B (caused by...

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Podcast 529: Hemophilia

Podcast 528:  Decompensated Liver Failure 

Contributor: Michael Hunt, MD Educational Pearls: Cirrhosis is the end stage of chronic structural damage to the liver. This is most commonly due to  alcohol but other causes viral hepatitis and hepatotoxic drugs Cirrhotic patients are very prone to GI bleeding and infections, partially due to the role the liver plays in producing immune and...

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Podcast 528:  Decompensated Liver Failure 

Podcast 527: Knee Dislocations

Contributor:  Erik Verzemnieks, MD Educational Pearls: Knee dislocations are most common in high energy trauma, such as a motor vehicle accident The knee may appear grossly normal on initial inspection since dislocations can spontaneously reduce – Look for such findings as hemarthrosis, instability, or ecchymosis, as clues to an occult dislocation.  Knee dislocations are often...

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Podcast 527: Knee Dislocations

Podcast 526:  Desmopressin for Intracranial Hemorrhage 

Contributor: Charleen Melton, PharmD Educational Pearls: Desmopressin (DDAVP) is an analogue of anti-diuretic hormone (ADH) that has been used for the treatment of intracranial hemorrhage. It works by increasing the release of Von Willebrand factor, helping to stabilize clots.  The use of DDAVP for intracranial hemorrhage in patients on antiplatelet agents (mainly Aspirin and Plavix)...

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Podcast 526:  Desmopressin for Intracranial Hemorrhage 

Podcast 525:  Enjoyable Epistaxis?

Contributor: Jared Scott, MD Educational Pearls: The ED is full of painful procedures. One of the most commonly dreaded procedures is nasal packing for epistaxis, as it is quite uncomfortable for the patient.  A recent study compared TXA with compression, saline with compression, and traditional nasal packing for the treatment of epistaxis.  Hemostasis was achieved...

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Podcast 525:  Enjoyable Epistaxis?

Podcast 524:  Bacterial Endocarditis 

Contributor: Sue Chilton, MD Educational Pearls: More intracardiac devices and injection drug abuse are thought to be increasing incidence of endocarditis Classic signs of endocarditis have included: Osler nodes (painful hemorrhagic lesions on hands and feet), Janeway lesions (painless hemorrhagic lesions on the hands and feet), and splinter hemorrhages in the nail beds Other classic...

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Podcast 524:  Bacterial Endocarditis 

Podcast 523:  A Dizzying Diagnosis 

Contributor: Don Stader, MD Educational Pearls: It can be difficult to distinguish between central and peripheral causes of vertigo. Cerebellar stroke should be considered with any dizzy patient.  Signs and symptoms that suggest stroke as the cause of vertigo include: ataxia, cranial nerve deficits, and rapid onset of symptoms When cerebellar stroke is being considered,...

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Podcast 523:  A Dizzying Diagnosis 

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