In this episode, Dr. Tiffany Proffitt talks with Dr. Andy Little about career and life transitions during the COVID pandemic. They discuss the unique challenges of moving his family across the US from Ohio to Florida in the pursuit of the career for which they had planned and sacrificed. Dr. Little shares with us how the pandemic forced him to refocus on the things that matter most and helped him discover new adventures with his family. 

Core Questions

1. Outline the anatomic contents of the female pelvis.
2. Describe an approach to the history in a patient with acute pelvic pain.
3. Describe an approach to the physical examination in the patient with acute pelvic pain.
4. List 10 differential diagnoses for the patient presenting with acute pelvic pain. (Box 30.1)
5. Outline an approach to ancillary testing for the patient presenting with acute pelvic pain.
6. What must be seen on bedside ultrasound to confirm a definitive intrauterine pregnancy (IUP)?

Wisecracks

1. What is the incidence of domestic violence in patients presenting with pelvic pain? 
2. What is the incidence of heterotopic pregnancy in the general population and in those that have conceived using reproductive technology?
3. Under what circumstances can a pelvic examination be omitted in a patient presenting to the ED with acute pelvic pain?
4. What is the classic triad of pelvic inflammatory disease (PID)?

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

1. List risk factors for constipation .
2. List 10 causes of constipation (Box 29.1).
3. Describe an approach to the history and physical exam of the constipated patient. 
4. What ancillary testing should and should not be ordered in constipation? 
5. Describe an approach to management of constipation in the ED (figure 29.1) .
6. Describe 5 classes of laxative agents.
7. List the lifestyle changes that constipation patients should be counselled about.  

Wisecracks

1. List 5 medications that can cause constipation. 
2. What agents can be considered in refractory opioid-induced constipation? 
3. Describe the mechanism of action of PEG 3350. 
4. Describe the mechanism of overflow incontinence.

Core Questions

1. Define diarrhea.
2. Outline the pathophysiologic processes that result in diarrhea.
3. List 10 infectious causes of diarrhea. - Box 28.1
4. List 10 non-infectious causes of diarrhea. - Box 28.2
5. Outline 5 important aspects of a patient’s history to elucidate in cases of diarrhea.
6. Detail an approach to laboratory testing in the patient with diarrhea.
7. When are empiric antibiotics indicated for the treatment of diarrheal illnesses?

Wisecracks

1. What antibiotics are most commonly implicated with precipitating C.difficile diarrhea?
2. What factors increase the probability of non-benign diarrheal illness?
3. Outline the constituent ingredients contained within the World Health Organization’s rehydration formula.
4. 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

1. Define upper gastrointestinal versus lower gastrointestinal bleeding and differentiate between the two based on anatomic location 
2. Outline an approach to the history and physical examination for the patient with complaints consistent with GIB.- Box 27.3
3. List 5 causes of UGI bleeding and 5 causes of LGI bleeding- Table 27.1
4. Outline six alternative diagnoses or mimics of GI bleeding - Box 27.1
5. List five characteristics of patients with high-risk GI bleeds - Box 27.2
6. Describe an approach to ancillary testing in the patient with GI bleeding.
7. List five substances that when ingested, can result in a falsely-positive stool guaiac study
8. Outline an approach to the management of the patient with GI bleeding - Fig 27.3
9. Detail the Blatchford and Clinical Rockall Risk Scores - Tables 27.3/27.4

Wisecracks

1. Outline the three most common causes of UGIB in pediatric and adult patients.
2. Outline the three most common causes of LGIB in pediatric and adult patients.
3. What percentage of patients presenting with hematochezia actually have an UGIB?
4. What volume of blood loss is needed to produce symptoms of anemia in the patient with an acute/subacute GI bleed?

Core Questions

1. Define the following terms:
2. 1. Nausea
   2. Retching
   3. Vomiting
3. Outline the neural pathway regulating nausea and vomiting.
4. List 6 potential sequelae of vomiting.
5. Outline an approach to the history in the patient complaining of nausea and vomiting.
6. Outline an approach to the physical exam in the nauseated and/or vomiting patient.
7. List 10 differential diagnoses for the vomiting patient.
8. What ancillary tests are indicated in the patient with nausea and/or vomiting?
9. List five antiemetics that can be used to treat the nauseous and vomiting patient.

Wisecracks

1. What are the three phases of vomiting? 
2. What is Hamman’s Sign and what pathology does it point to?
3. What medication is indicated in the patient with intractable chemotherapy-induced nausea and vomiting.