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Podcast #53: PERC and WELLS Score for PE

Run Time: 4 minutes Author: Dr. Martin O’Bryan Educational Pearls: PERC Score: age >50, HR <100, O2 >95%, no history of PE or DVT, no recent trauma, no hemoptysis, no oral contraceptive, and no unilateral leg swelling. If all are negative then probability of a PE is under 2%. A WELLS Score of <4 =…

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Podcast #52: Syphilis the Great Imitator

Run Time: 7 minutes Author: Dr. Donald Stader Educational Pearls: Syphillis is a very important historical and current disease. The study of Syhpillis or “Syphilology” evolved into the field of dermatology. Syphilis, an is caused by the spirochete bacteria, Treponema pallidum.  Syphilis comes in three stages: primary, secondary, and tertiary stages. In the primary stage, they…

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Podcast #51: Diverticulitis

Run Time: 3 minutes Author: Dr. Michael Hunt Educational Pearls: Diverticulitis is the inflammation of diverticula or projecting pockets coming off of the colon. 2-4% of the population have this and 15-30% have recurrences of diverticulitis. Most of these cases do not have any complications. Flagyl and ciprofloxacin are given normally to treat the infection…

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Podcast #50: Pleural Effusion

Run Time: 4 minutes Author: Dr. Peter Bakes Educational Pearls: 75% of pleural effusions seen in US emergency rooms are caused by one of three non-trauma diagnoses: congestive heart failure, infection, and cancer. First test of choice without history is a diagnostic aspiration of the pleural fluid. This determines if the pleural effusion is transudate or…

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Podcast #49: Benzodiazepine Withdrawal

Run Time: 4 minutes Author: Dr. David Rosenberg Educational Pearls: Benzodiazepine withdrawal and alcohol withdrawal are similar due to their interaction with GABA receptors in the brain except benzodiazepine withdrawals can occur weeks after you stop taking the medication. This is due to the long half-life of certain benzodiazepines. Treatment for benzodiazepine withdrawals includes putting the…

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Podcast #48: Alcoholic Ketoacidosis

Run Time: 4 minutes Author: Dr. Eric Miller Educational Pearls: Alcoholic ketoacidosis occurs in chronic alcohol abusers who have low glycogen supplies and are dehydrated causing an overproduction of glucagon. This condition is very similar to diabetic ketoacidosis. The patients can have a ketotic smell to indicate alcoholic ketoacidosis, they also usually have a high…

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Podcast #47: Broken Penis

Run Time: 2 minutes Author: Dr. Erik Verzemnieks Educational Pearls: During an erection the corpus cavanosum fills with blood, when enough stress is placed on the penis during an erection the surrounding tissue can rupture. A broken penis most often occurs during intercourse in the “reverse cowgirl” position. This condition requires surgical repair of the…

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Podcast #46: Burn Victims and Cyanokit

Run Time: 3 minutes Author: Rachael Duncan, PharmD BCPS Educational Pearls: The two most important treatments for burn victims are analgesia and fluids. The number one cause of mortality associated with fires is smoke inhalation, causing carbon monoxide poisoning and/or cyanide toxicity. Cyanide toxicity changes aerobic metabolism to anaerobic metabolism causing lactic acidosis. In burn…

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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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