Crackcast & Physicians As Humans On Canadiem

In this week’s episode, we are covering how to get to know more about programs and give you some quick pointers on how to create your personal letters! Here to help us tackle this topic is our guest: Dr. Pardhan! Dr. Kaif Pardhan is an emergency medicine physician and Deputy Chief of the ED at Sunnybrook Health Sciences Centre in Toronto. He serves as the Assistant Program Director for the University of Toronto’s emergency medicine residency program. He also works as a pediatric emergency physician at McMaster Children’s Hospital in Hamilton. Click Here for more information about today's episode. 

In this episode of Clerkcast Lauren and Ben are teaming up with Dr. Kaif Pardhan to cover an approach to pediatric fever. 

This episode is the first of the Physician Passion Projects series, a podcast focused on highlighting Canadian EM physicians' work outside of clinical medicine. 

Core Questions List risk factors for constipation . List 10 causes of constipation (Box 29.1). Describe an approach to the history and physical exam of the constipated patient.  What ancillary testing should and should not be ordered in constipation?  Describe an approach to management of constipation in the ED (figure 29.1) . Describe 5 classes of laxative agents. List the lifestyle changes that constipation patients should be counselled about.   Wisecracks List 5 medications that can cause constipation.  What agents can be considered in refractory opioid-induced constipation?  Describe the mechanism of action of PEG 3350.  Describe the mechanism of overflow incontinence.

Core Questions Define diarrhea. Outline the pathophysiologic processes that result in diarrhea. List 10 infectious causes of diarrhea. - Box 28.1 List 10 non-infectious causes of diarrhea. - Box 28.2 Outline 5 important aspects of a patient’s history to elucidate in cases of diarrhea. Detail an approach to laboratory testing in the patient with diarrhea. When are empiric antibiotics indicated for the treatment of diarrheal illnesses? Wisecracks What antibiotics are most commonly implicated with precipitating C.difficile diarrhea? What factors increase the probability of non-benign diarrheal illness? Outline the constituent ingredients contained within the World Health Organization’s rehydration formula. What is the BRAT diet and why is it recommended in patients with acute diarrheal illnesses?

In today’s episode, we cover how to prepare for your upcoming emergency medicine elective and how best to ask for that coveted reference letter. Helping us navigate this subject is our expert guest Dr. Brent Thoma. Dr. Thoma works clinically as a trauma and emergency medicine physician. Academically, he studies technology-enhanced medical education and works for the Royal College of Physicians and Surgeons of Canada as a Clinician Educator. He is also the CEO of CanadiEM. Click here for resources mentioned in today's episode. 

Core Questions   Define upper gastrointestinal versus lower gastrointestinal bleeding and differentiate between the two based on anatomic location  Outline an approach to the history and physical examination for the patient with complaints consistent with GIB.- Box 27.3 List 5 causes of UGI bleeding and 5 causes of LGI bleeding- Table 27.1 Outline six alternative diagnoses or mimics of GI bleeding - Box 27.1 List five characteristics of patients with high-risk GI bleeds - Box 27.2 Describe an approach to ancillary testing in the patient with GI bleeding. List five substances that when ingested, can result in a falsely-positive stool guaiac study Outline an approach to the management of the patient with GI bleeding - Fig 27.3 Detail the Blatchford and Clinical Rockall Risk Scores - Tables 27.3/27.4   Wisecracks   Outline the three most common causes of UGIB in pediatric and adult patients. Outline the three most common causes of LGIB in pediatric and adult patients. What percentage of patients presenting wi

Core Questions Define the following terms: Nausea Retching Vomiting Outline the neural pathway regulating nausea and vomiting. List 6 potential sequelae of vomiting. Outline an approach to the history in the patient complaining of nausea and vomiting. Outline an approach to the physical exam in the nauseated and/or vomiting patient. List 10 differential diagnoses for the vomiting patient. What ancillary tests are indicated in the patient with nausea and/or vomiting? List five antiemetics that can be used to treat the nauseous and vomiting patient. Wisecracks What are the three phases of vomiting?  What is Hamman’s Sign and what pathology does it point to? What medication is indicated in the patient with intractable chemotherapy-induced nausea and vomiting.

In this episode of Danger Zone, our hosts examine a relatively rare procedure performed in the ED – the Surgical Airway! They discuss indications, procedural considerations, and important clinical pearls.

Core Questions Explain broad causes of elevated bilirubin (obstructive, hepatocellular, and hemolysis) and the significance of direct vs. indirect hyperbilirubinemia (Fig 25.1) Explain your approach to the history and physical exam in patients with jaundice (Fig 25.2)  List 10 causes of jaundice (Table 25.2)  Explain your approach to ancillary testing in patients with jaundice.  Wisecracks What are the stages of hepatic encephalopathy?   What is the triad of acute hepatic failure?  What is Charcot’s triad and Reynold’s pentad?  What is the “1000s Club” and how do you become a member? 

In this episode, Kevin Dong interviews Dr. Mohamed Hagahmed on his transition to practice and how to prepare for your board/licensing exams after you graduate from residency. Dr. Mohamed Hagahmed is an Assistant Clinical Professor in the Department of Emergency Medicine at UT Health San Antonio.

Core Questions What are risk factors for serious underlying causes of abdominal pain? (Box 24.1)  Explain key symptoms and signs to look for in the evaluation of the patient with abdominal pain.  What diagnoses are associated with different patterns of abdominal pain? (Fig 24.1)  List 5 critical and 5 emergent causes of abdominal pain (Table 24.1, 24.2)  Explain an approach to ancillary testing in abdominal pain.  Outline a diagnostic algorithm for patients with abdominal pain (Fig 24.4)  Outline an empiric management algorithm for abdominal pain. (Fig 24.5)  Wisecracks What are the structures included in the foregut, midgut, and hindgut? More importantly, why do you care?  List indications for bedside US in the ED patient with abdominal pain (Table 24.3)  Explain how referred pain works in the setting of abdominal pain (Fig 24.2)    

In this episode of First Year Diaries, I am joined by Dr. Daniel Ting and Dr. Jared Baylis. Dr. Daniel Ting is a first-year staff at UBC, who is currently working from the Vancouver General Hospital and BC Children’s Hospital. Dr. Jared Baylis is also a first-year staff, working at the Kelowna General Hospital. I asked them what it is like to transition from residency to working as staff physicians. Later, we discussed the challenges they face as staff physicians and how residency prepared them for life as Emergency Physicians. 

Core Questions Describe an approach to key history and physical exam for chest pain patients presenting to the ED. (Table 23.2 and 23.3)  List 5 critical diagnoses, 5 emergent, and 5 nonemergent diagnoses to consider in the patient presenting with chest pain. (Table 23.1) Describe an approach to the critically ill patient with undifferentiated chest pain. (Figure 23.1) Describe an approach to ancillary testing in chest pain. (Table 23.4 and 23.5) List the risk factors associated with each critical chest pain diagnosis (Box 23.1)  Explain the approach to risk stratification of ED chest pain patients.  Wisecracks What are the X-ray findings of aortic dissection?  What are your HR and BP targets in Aortic dissection?  List the components of the HEART score. 

Today we are sitting down with Dr Alim Pardhan. Dr Pardhan is the FRCP EM program director at McMaster University, Hamilton General Hospital ED side lead, and a passionate medical educator. Your key takeaways from this episode are: Understanding the mechanisms behind fever and hyperthermia The causes of hyperthermia - think drugs, CNS infections, thyroid storm, and environmental exposure Five big, bad, and deadly causes of fever in our patients in the ED - necrotizing fasciitis! Endocarditis! Meningitis! Ascending cholangitis! Sepsis! Identification and management of the patient with sepsis

Core Questions Define the following terms: Dyspnea Tachypnea Hyperpnea Hyperventilation Dyspnea on exertion Orthopnea Paroxysmal Nocturnal Dyspnea What anatomical structures are responsible for controlling respiratory effort? Outline an approach to the history for the dyspneic patient. Detail the physical examination for the dyspneic patient and highlight pivotal exam findings that point to specific pathologies. Outline the differential diagnosis for the patient presenting with dyspnea and highlight 5 critical, 5 emergent, and 5 non-emergent causes of shortness of breath. What ancillary tests are indicated for the dyspneic patient? Detail the utility of point-of-care ultrasound in the assessment of the dyspneic patient. Outline a management algorithm for the acutely dyspneic patient. Wisecracks List three findings on chest radiograph suggestive of pulmonary embolism. What is the utility of venous blood gas testing and how do its values correlate with that of an arterial blood gas?

Core Questions:    Define “massive hemoptysis”. Which vessels, when injured, are typically associated with small and massive hemoptysis, and how do the vessel characteristics influence the degree of bleeding? Outline an approach to the history and physical examination for a patient presenting with hemoptysis. Outline the differential diagnosis for hemoptysis and highlight five critical and five emergent diagnoses that cause hemoptysis. (Box 21.1 and 21.2) What ancillary tests are warranted in the patient with hemoptysis? Detail the utility of imaging studies in patients with hemoptysis. Detail the diagnostic approach to the patient with hemoptysis. (Figure 21.1) Outline an approach to managing the patient with hemoptysis. (Figure 21.2) What two maneuvers can be used to address massive hemoptysis from a suspected tracheo-innominate fistula (TIF)? What strategies can be used to improve oxygenation in the patient with massive hemoptysis? Wisecracks:  List one gynecologic cause of hemoptysis. List five cause

We are finally back with episode 3 of ClerkCast! Today we will be talking about ABDOMINAL PAIN with McMaster FRCP EM resident Dr Rakesh Gupta Key takeaways from this episode include: 1. Thinking outside the GI tract for patients with abdominal pain 2. The importance of a good physical exam 3. What type of imaging is best for your patient? Hint: it depends! 4. How to consult your inpatient colleagues! P-I-Q-U-E-D Thanks for the listen!

Core Questions:    What are the three anatomically-distinct zones of the pharynx, and what structures outline their borders? Ultrasound of the Neck Lateral neck radiograph Nasopharyngoscopy CT Soft Tissues Neck Describe the utility of the following imaging modalities in the patient with sore throat. Outline five viral, five bacterial, and five other potential aetiologies of sore throat in the ED patient? (Table 20.1) Outline the components of the Modified Centor Score and describe its application. Describe the diagnostic algorithm for the patient with sore throat. (Figure 20.4) Outline the approach to managing a patient with sore throat in the ED. (Figure 20.4) What antibiotics can be used in the  patient with suspected or confirmed streptococcal pharyngitis? (Box 20.2)   Wisecracks:    In what age groups is streptococcal pharyngitis rarely seen? What is Waldeyer’s Tonsillar Ring? What is the “thumb sign” and what pathology does it point to?

Core Questions:    Detail the pertinent points to review when taking the history of a patient presenting with a red and painful eye - Box 19.2 Outline an approach to the ocular physical examination - Box 19.3 Outline the components of the slit lamp examination - Box 19.4  What signs and symptoms, if present, likely indicate the presence of serious ocular pathologies - Box 19.1 What is a relative afferent pupillary defect and what conditions cause it? List ten causes of increase intraocular pressure List five causes for an absent red reflex - Box 19.5 Name three critical, emergent, urgent, and non-urgent causes of the red and painful eye? - Figure 19.8   Wisecracks:    What are the fundoscopic findings of a central retinal artery occlusion. What is the pinhole test and what visual disturbances does it correct? What are the three most common causes of an irregularly shaped pupil What is Seidel’s Test and what condition does it identify?