Author: Nick Hatch, M.D. Educational Pearls Acyclovir toxicity can uncommonly cause altered mental status, low blood glucose, hallucinations and myoclonic jerks. Toxicity often occurs in the setting of renal insufficiency, as it is cleared by the kidneys. Acyclovir is often used to treat shingles, which can also cause similar symptoms as acyclovir toxicity due to…

  Author: Michael Hunt, M.D. Educational Pearls Wells Criteria was initially designed to screen patients for further workup for PE.   Aspects of the Wells Criteria include: signs and symptoms of DVT (3 points), PE most likely dia (3 points), HR > 100 (1.5 points), immobility for > 3 days or surgery in last 4…

Podcast #221: Walking Corpse Syndrome Author: Erik Verzemnieks, M.D. Educational Pearls Walking Corpse Syndrome (aka Cotard Delusion) is a very rare psychiatric disorder that leads to the belief that one is a “walking corpse”. Often co-presents with depression, schizophrenia, and starvation. Responds to ECT. References: https://en.wikipedia.org/wiki/Cotard_delusion

Author: Aaron Lessen, M.D. Educational Pearls Atrial fibrillation is common. One of the best treatments for a fib is cardioversion back into sinus rhythm. Cardioversion may increase stroke risk if A-Fib duration is greater than 48 hours, but some new data suggests that this risk may happen as soon as 12 hours. However, newer studies…

  Author: Chris Holmes, M.D. Educational Pearls “Sepo’ is a term from Homer (author of The Iliad and The Odyssey), and means “I rot”. Hippocrates in 400 BC identified sepsis as a “dangerous decay within the body”. Galen in 200 AD believed pus was “laudable”. The Greeks and Romans used the term “myasma” to describe the smell of…

Author: Aaron Lessen, M.D. Educational Pearls Asking parents and Broselow Tape are common options for estimating pediatric weight. Equipment sizes should not be adjusted for under/overweight kids based on Broselow Tape estimates. The finger counting method (see reference) is just as accurate as Broselow Tape method, according to one study. References: http://handtevy.com/images/Casestudies/Americanjournalofemergencymedicine.pdf

Author: John Winkler, M.D. Educational Pearls: Designer, or “synthetic” drugs include bath salts, synthetic THC, and many others. Many of these drugs are originally manufactured in China and are shipped globally. Treatment usually involves airway control and sedation – ketamine may be useful. Traditional tox screens do not test for these drugs. References: https://www.drugabuse.gov/related-topics/trends-statistics/national-drug-early-warning-system-ndews

Author: Aaron Lessen, M.D.  Educational Pearls: Anecdotal evidence suggests that roller coasters may help with kidney stones. A recent study used a model of a kidney and ureter with different sized stones and put it on Thunder Mountain roller coaster in Disney World. There was “dramatic passage” of the kidney stones at the rear of…