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. ...
Mar 03, 2020•32 min•Ep. 211
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 ...
Feb 05, 2020•1 hr 16 min•Ep. 210
Core Questions: What is diplopia and how is it classified? What four questions help clinicians delineate the potential cause of a patient's diplopia? What are the cardinal directions of gaze and how are they tested? Outline the physical exam for the patient with monocular and binocular diplopia. Outline the DDx for monocular diplopia? Outline the DDx for binocular diplopia? [Table 18.1] Detail the different oculomotor palsies. [Figure 18.3] Detail the various lacunar stroke syndromes. [Box 18.1]...
Jan 07, 2020•50 min•Ep. 209
Ruminations from two residents about handling and thriving in call shifts for medical students.
Jan 01, 2020•16 min
Welcome to ClerkCast! A podcast for medical students by medical students, focusing on cognitive approaches to common EM presentations. This episode covers how to approach patients with chest pain in the Emergency Department as a medical student with our guest co-host Dr. Shawn Mondoux, staff EM doc at St Joseph's Hospital in Hamilton, and a Quality Improvement guru We cover: 1. The SIX CAN'T MISS chest pain diagnoses 2. Acute coronary syndrome and the Terrible Triad 3. Aortic dissection history ...
Dec 16, 2019•45 min
Core Questions: List three primary headache disorders Describe the pathophysiology of migraines and name three Emergency Department treatments for same List five critical and five emergent causes of headache (Table 17.1) Outline your approach to the history for the patient presenting with headache ( Box 17.1) Outline your approach to the physical exam for the patient presenting with headache (Table 17.3) Describe your diagnostic approach to the patient with a suspected SAH Detail the findings on...
Dec 02, 2019•56 min•Ep. 208
An intro to the latest CanadiEM podcast, ClerkCast! Hosted by two McMaster medical students, Lauren Beals and Ben Forestell, ClerkCast is your one stop shop for approaches to common EM presentations... enjoy!
Nov 29, 2019•6 min
Welcome to ClerkCast! A podcast for medical students by medical students, focusing on cognitive approaches to common EM presentations. This episode covers how to succeed in the Emergency Department as a medical student with our guest co-host Dr. Teresa Chan, staff EM doc at Hamilton Health Sciences, CanadiEM co-founder, and medical educator extraordinaire We cover: 1. How to structure your differential diagnosis in the ED 2. Eye-balling a patient - edits have been made clarifying the ABCs 3. How...
Nov 29, 2019•35 min
On this episode of First Year Diaries, I am joined by Dr. Mike Kirlew, a rural family and emergency medicine physician from Sioux Lookout in Northern Ontario. I asked him about how he ended up working in a rural area, and what it is like working with scarce medical resources. Later, we discussed how a resident physician can prepare themselves for working in a rural community, and how best to transition to living in a rural area.
Nov 26, 2019•44 min
Core Questions: What is dizziness and what pathologies can cause it? Define vertigo and acute vestibular syndrome What three systems are involved in the maintenance of equilibrium and how many of these systems must be affected to cause vertigo? Trace the neuronal impulse from the vestibular apparatus to the muscle endplate Define nystagmus List five peripheral causes of vertigo (see Table 16.2) List five central causes of vertigo (see Table 16.2) Differentiate between central and peripheral vert...
Nov 04, 2019•52 min•Ep. 207
Core Questions: Define seizure and provide an explanation of the classification systems for seizure Define recruitment as it relates to seizure development and progression Differentiate between seizure and syncope Differentiate between neurogenic and psychogenic seizures List 5 diagnoses that can mimic seizures (see Box 15.2) Define status epilepticus and differentiate between convulsive and non-convulsive status epilepticus List 10 causes of status epilepticus in adults (see Box 15.1 and 15.3) ...
Oct 07, 2019•45 min•Ep. 206
The same 65-year-old man who was seen earlier with an ICH has now recovered. His past medical history is remarkable for hypertension, dyslipidemia, a mechanical aortic valve replacement, diabetes, and sleep apnea. His list of medications include ramipril, atorvastatin, aspirin, metformin, and warfarin. Should his anti-coagulation be resumed? If so, how long should the clinician wait prior to re-starting his medications? Objective 1: Summarize the most recent guidelines regarding when to re-start...
Sep 16, 2019•22 min
Core Questions: Define confusion. What is your differential diagnosis for the confused patient? Differentiate between organic and functional causes of confusion. What is the Quick Confusion Scale (QCS) and how is it calculated? What is the Brief Confusion Assessment Method (bCAM) and how is it used? What is the Mini-Mental State Examination (MMSE) and how is it scored? What ancillary tests are used when working up the confused patient? What is the role of thiamine in the treatment of the acutely...
Sep 03, 2019•38 min•Ep. 205
Today on First Year Diaries I am joined by Dr. David Carr, a University Health Network emergency physician, renowned medical education speaker, and Toronto Blue Jays physician. In this episode, I asked him to impart his wisdom to new staff physicians like myself and share his approaches to a successful career in medicine. Later in the interview, we also discuss workflow strategies for the ED, common mistakes made by new physicians, and tips on how to maintain wellness/avoid burnout. Questions: 0...
Aug 23, 2019•40 min
Core Questions: 1. Define coma and differentiate coma from lethargy and stupor. 2. Name five neuroanatomic structures involved in maintaining arousal. 3. List five critical and five emergent causes of depressed consciousness. (see Table 13.1) 4. Describe your approach to the history and physical examination for the patient with depressed consciousness. 5. Outline your exam to accurately assess the Glasgow Coma Scale (GCS). (see Table 13.2) 6. What is the FOUR score, and how is it calculated? (se...
Aug 05, 2019•35 min•Ep. 204
Core Questions: List 10 life-threatening causes of syncope List 10 medications that can precipitate syncope What are the red flags on history and physical exam in syncope? What are markers of increased short-term risk in syncope patients? (box) What are 5 ECG findings to look for in the syncopal patient? List five indications for admission and inpatient evaluation for the patient with syncope? Wisecracks: What is the significance of a patient presenting with syncope vs. near syncope? What is the...
Jul 01, 2019•28 min•Ep. 203
Core Questions: Define cyanosis and explain what causes it? What is central cyanosis and what typically causes it? What is peripheral cyanosis and what typically causes it? At what concentration of deoxyhemoglobin does cyanosis present? List 10 differential diagnoses for cyanosis - Box 11.2? Describe your initial workup for the patient with cyanosis.- Figure 11.3/11.4 What is the oxyhemoglobin dissociation curve and what information can be taken from it? - Figure 11.1 Name four factors that shif...
Jun 03, 2019•47 min•Ep. 202
From CAEP 2019 I always love the activities and experiences at CAEP, but year after year I'm drawn to the Simulation Olympiad. Every time I think it's just incredible. This year, I decided to talk with some of the people who make the SIMOlympiad such a great experience for audiences and participants alike. In my first interview, I heard about what the average SIM team looks like, how the competition runs, and what the scope of the material covers. We also got the details on what the characterist...
May 29, 2019•13 min
May 23, 2019•5 min
Core Questions: 1. What structures are affected by UMJ, LMJ, and NMJ lesions, and what are causes of weakness associated with each? 2. What are common signs of UMN, LMN, and NMJ dysfunction? 3. What are (7) pathophysiologic causes of non-neurologic weakness (Box 10.1)? 4. What is the DDx of neuromuscular weakness? (Table 10.1) 5. Describe an approach to general weakness in the ED. Wisecracks: 1. Differentiate between "plegia" and "paresis". 2. List (5) DDx's for non-neurologic weakness (based on...
May 06, 2019•29 min•Ep. 201
Today's episode is to aid new physicians to traverse through the first few months of their independent practice safely and effectively. As a new physician myself, I had the luxury of having many mentors and colleagues who were gracious enough to help me find my way in providing safe patient care. Additionally, they assisted me on integral aspects that we don't necessary learn or get exposed to as a resident, such as billing, department flow, and the politics of the ED. However, as a new staff, t...
Apr 09, 2019•39 min
Core Questions: What structure controls body temperature and how does it go about controlling it? What are pyrogens and how are they classified? What is the difference between fever and hyperthermia? What is the role of PGE2 in fever and what medications can you give to combat its effects? List four factors that blunt the febrile response. What are the benefits and pitfalls of the febrile response? List five infectious and five non-infectious causes of fever. (see Box/Table 9.1) Describe your ap...
Apr 01, 2019•24 min•Ep. 200
Core Questions: Describe your history and physical exam in the patient being actively resuscitated. Discuss the process of deterioration to cardiac arrest with respiratory failure and cardiac obstruction. List 6 aspects of optimal CPR. What medications have been shown to improve outcomes in cardiac arrest? List 8 differential diagnoses for PEA arrest (See Table 8.4) What is electromechanical dissociation (EMD) and how does it differ from pseudo electromechanical dissociation (pseudo EMD)? What i...
Mar 04, 2019•36 min•Ep. 199
Core Questions: What is cerebral autoregulation? Describe your parameters for post-arrest care of a brain injured patient. List 7 interventions for management of a patient with elevated ICP. What are the equations for cerebral blood flow and cerebral perfusion pressure? Describe a protocol for induced hypothermia after cardiac arrest. In the patient with a traumatic brain injury, what is the optimal drug for and duration of seizure prophylaxis? Wisecracks: What are Lundberg A waves? What is the ...
Feb 04, 2019•34 min•Ep. 198
This episode covers Chapter 6 in Rosen's 9th edition, shock.
Jan 07, 2019•42 min•Ep. 197
Are you a Family Medicine resident about to graduate and embark on an extra year of training in Emergency Medicine (EM)? Are you worried you don't know what it is really like to be an Emergency Medicine resident and you want to find a guide to help maximize your learning in a short and extremely fast year? As a recent CCFP-EM graduate, I can strongly relate to your fears. The one year of extra training is an important one, and you will learn a plethora of information that will be pertinent to yo...
Jan 02, 2019•13 min
This updated episode of CRACKCast covers Rosen's Chapter 005, Monitoring the Emergency Patient (9th Ed.). Core Questions: List modalities for measurement of BP and note which modalities are likely to over and underestimate blood pressure. What is pulse pressure and how does it relate to stroke volume? List 4 indications for an arterial line. What is the Beer-Lambert Law and how does it allow us to measure pulse oximetry? How do dyshemoglobinemias affect your measured SpO2? What are the 4 phases ...
Dec 03, 2018•32 min•Ep. 196
This updated episode of CRACKCast cover's Rosen's Chapter 004, Procedural Sedation and Analgesia (9th Ed.).
Nov 05, 2018•33 min•Ep. 195
This episode of CRACKCast covers Chapter 3 in Rosen's Emergency Medicine (9th Ed.) – Pain Management. This podcast will give you a solid approach to the basics pain management to use on your next shift! Core Questions: 1. Define the following terms (Box 3.1): Allodynia Amnesia/amnestic Local anesthesia Analgesia Hypnotic Narcotic Nociceptor Noxious stimulus Opiate Opioid Pain Procedural Sedation Sedative 2. Describe a practical approach to stepwise management of pain in the ED. 3. Describe the a...
Oct 01, 2018•34 min•Ep. 194
The first episode of the Thrombophonia podcast addresses three objectives: 1. Summarize an approach to the acute management of patients with intracerebral hemorrhage while on anticoagulation for a mechanical heart valve 2. Describe the benefits and risks of anticoagulant reversal, including the risk of thromboembolism 3. Describe the principles of effective communication and collaboration of bleeding & clotting cases with consultants
Sep 11, 2018•32 min
