Medical Minute Archives - Page 4 of 68 - The Emergency Medical Minute

Medical Minute

Podcast 651: Hereditary Angioedema

Contributor:  Katie Sprinkel, MD Educational Pearls: Hereditary angioedema (HA) is an autosomal dominant bradykinin-mediated disease affecting the airway, skin or gastrointestinal tract and typically presents with swelling in the absence of pruritus HA episodes last 3-5 days, typically occur first in childhood or adolescence, and decrease in frequency with aging Airway angioedema is the most…

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Podcast 650: PNES

Contributor:  Katie Sprinkel, MD Educational Pearls: Psychogenic Non-Epileptic Seizures (PNES) are due to a psychogenic rather than an epileptic cause Despite common assumption, PNES are not always volitional  20-40% of those with PNES can also have true epileptic seizures 20-40% True diagnosis requires a video EEG  Characteristics of PNES include: Waxing and waning of the…

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Podcast 649: Normal Triage EKGs

Contributor:  Samuel Killian, MD Educational Pearls: Anecdotally, when the computer reads a triage EKG as normal it is most often normal One study tested this theory by examining 855 computer-read EKGS (222 of which were read as normal) Two cardiologists reviewed these 222 normal EKGs and only found 13 EKGs that were slightly abnormal with…

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Podcast 648: Ivermectin for COVID-19

Contributor:  Aaron Lessen, MD Educational Pearls: Ivermectin is an antiparasitic medication that has been used for a long time, but has sparked new interest in the past year as a potential treatment for COVID-19 In-vitro studies have shown it decreases how quickly COVID replicates and may make it less likely to adhere to cells Observational…

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Podcast 647: INR and Liver Failure

Contributor:  Erik Verzemnieks, MD Educational Pearls: INR measures the clotting cascade including factors II, VII, IX, and X Coumadin most commonly elevates the INR, and it is used to monitor the anticoagulant’s effectiveness Liver failure can cause a similar elevation in the INR due to lack of synthesis of factors II, VII, IX, X An…

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Podcast 646: Thunderclap Headache, Think…RCVS?

Contributor:  Aaron Lessen, MD Educational Pearls: When evaluating a thunderclap headache, don’t forget RCVS! RCVS: reversible cerebral vasoconstriction syndrome Due to reversible spasms of cerebral blood vessels Can sometimes be seen on CTA or MRA, but often the imaging is normal and formal angiograms only occasionally show it It can be caused by medications, intense…

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Podcast 645: Necrotizing Enterocolitis and More

Contributor:  Peter Bakes, MD Educational Pearls: Necrotizing Enterocolitis (NEC) Presents in the first few days of life (often in the NICU) to 3 weeks old Risk factors include prematurity, excess feeding, neonatal sepsis Pneumatosis Intestinalisis on abdominal xray caused by bacterial translocation into the bowel wall Treated with NG tube, bowel rest and surgical resection…

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Podcast 644: Covid Outcomes

Contributor:  Aaron Lessen, MD Educational Pearls: Meta-analysis of 57,420 COVID+ patients evaluated mortality after intubation 45% mortality rate for all patients in the study 84.4% mortality in patients over 80 years old POSITIONED Trail assessed need for intubation in patients awake self-proning compared to not Risk of intubation and mortality was lower for those self-proning…

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Podcast 643: Convulsions with Gastroenteritis

Contributor:  Jared Scott, MD Educational Pearls: Differential Diagnosis: non-accidental trauma, febrile seizure, meningitis, hyponatremia, epilepsy Convulsions with gastroenteritis is a known entity to cause seizures in infancy Predominantly occurs in ages 6 months to 3 years Occur with diarrheal episodes No electrolyte abnormalities associated with the seizure nor severe dehydration Seizures tend to come in…

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Podcast 642: Vasopressors

  Contributor:  Nick Tsipis, MD Educational Pearls: Epinephrine: alpha-1, alpha-2, beta-1, and beta 2 agonist – used in cardiac arrest with positive effects on ROSC in prehospital and peri-hopsital setting Norepinephrine: alpha-1 and beta-1 agonist – used in septic shock to increase cardiac output and peripheral vasoconstriction Phenylephrine: alpha-1 adrenergic agonist – used in spinal/neurogenic…

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