CRACKCast & Physicians as Humans on CanadiEM

This 134th episode of CRACKCast covers Rosen's 9th edition, Chapter 126, tick-borne illnesses. Can't get all those crazy rare diseases straight in your head? We've got you covered.

This episode of CRACKCast covers Rosen's Chapter 125, Parasitic Infections. This episode will give you the tools to adequately investigate the peculiar parasitic infections that present in patients coming to the ED. In an age where physicians are increasingly exposed to international travelers and immigrant/refugee populations, knowing this content is absolutely essential.

Core Questions:

1. Define AIDS
2. List 5 risk factors for AIDS
3. List 10 AIDS-defining conditions
4. Describe 3 serum tests for HIV
5. List 6 Ddx for respiratory infections in HIV
6. Describe the presentation and treatment of PCP pneumonia
7. Describe an approach to diagnosis and management of CNS infections in AIDS
8. List 5 causes of odynophagia in HIV
9. List 6 causes of diarrhea in the HIV patient
10. Describe HAART therapy
11. Describe prophylaxis of opportunistic infections in HIV

WiseCracks:

1. Risk stratify exposure to HIV
2. What is Coccidiomycosis?
3. Name common ART agents and their adverse effects

Core questions:

1. What are the top 5 rabies-virus carrying animals in Canada? In the world?
2. Describe the pathogenesis of the rabies virus disease (see fig. 123.6)
3. List 5 stages of rabies. What are the clinical presentations of rabies?
4. How is rabies diagnosed?
5. What factors are involved in a rabies risk assessment. Which types of animal contact require PEP?
   1. Non-immunized
   2. Immunized
6. Describe important aspects of rabies post-exposure immunoprophylaxis for the following exposures:

Wisecracks:

1. List 4 reservoirs of rabies
2. What is the dose of HRIG?

This 130th episode of CRACKCast covers Rosen's 9th edition, Chapter 122, Viruses. Viruses account for most infections and are typically self-limited illnesses. Recognition of specific viral illness patterns is important in the ED, where our intervention or withholding an ineffective treatment such as antibiotics can affect the health at a population level.

This 129th episode of CRACKCast covers Rosen's 9th edition, Chapter 121, Bacteria. Bacterial infections represent a large proportion of presentations to the emergency department. Here we examine some of the most infrequently seen but extremely dangerous bacterial infections that you must be able to recognize. For more frequent infections, please see their individual chapters in Rosen's.

This episode of CRACKCast covers Rosen's Chapter 120, Thyroid and Adrenal disorders. This episode is going to have a nice breakdown of how each of these major endocrine glands can go haywire and what to do when the storm approaches. The shownotes also have some additional material worth checking out!

This 127th episode of CRACKCast covers Rosen's 9th edition, Chapter 119, Rhabdomyolysis. Although usually benign, rhabdomyolysis can have deadly complications. Acute kidney injury and hyperkalemia are accompanied by high mortality. At-risk patients (see the "MUSCLE Breakdown" mnemonic) may present with muscle pain or altered mentation.

Core questions:

• Define DKA.

• List 6 potential triggers of DKA.

• Describe the pathophysiology of DKA. (Fig 118.1)

• How is DKA managed in children? In adults?

• What are the epidemiologic risk factors for cerebral edema in DKA?

• What are signs and symptoms of cerebral edema? How do you manage a pt with DKA and suspected cerebral edema?

• List 5 complications of DKA management

• List five common serious infections in diabetics and how they are managed.

• How does hypoglycemia classically present?

• List 10 causes of hypoglycemia

• Describe the treatment of hypoglycemia

• What is the definition of hyperglycemic, hyperosmolar state?

• Contrast DKA and HHS (Table 118.2)

• What is the pathophysiology of HHS?

• How is HHS managed?

WiseCracks:

• Why are urine ketones less sensitive for DKA than serum ketones?

• When do you give NaHCO3 to a patient with DKA?

• What is euglycemic DKA?

• What is the differential diagnosis of hypoglycemia in a patient who does not have DM? What would you add to the differential diagnosis in a pt who has DM?

Core questions

1. What are the five most common causes of hyperkalemia?

2. Describe the ECG features seen with hyperkalemia. List at least 5.

3. How is hyperkalemia managed? How does each intervention work, and how long do the effects typically last?

4. What are the five most common causes of hypokalemia?

5. Describe the ECG features seen with hypokalemia. List at least 4.

6. How is hypokalemia managed?

7. What are the three main types of hypernatremia? Give 3 examples of each.

8. List four central and four nephrogenic causes of diabetes insipidus.

9. What are the four broad categories of hyponatremia?

10. Give an example of two clinical conditions for each: hypovolemic, euvolemic and hypervolemic hyponatremia.

11. What are the three most common causes of SIADH?

12. Describe the management of hyponatremia in the following patients:

    1. Actively seizing

    2. Euvolemic with acute hyponatremia

    3. Hypovolemic with chronic hyponatremia

    4. Hypovolemic with acute hyponatremia

13. What are the five most common causes of hypercalcemia?

14. What are the five most common symptomatic causes of hypocalcemia seen in the emergency department?

15. What ECG features are seen in hypercalcemia vs. hypocalcemia? How is each managed?

16. What are the five most common causes of hypermagnesemia?

17. List five clinical manifestations of hypermagnesemia.

18. List five common causes of hypomagnesemia.

19. What are the five most common causes of hyperphosphatemia?

20. What are the five most common causes of hypophosphatemia in the ED? How do they manifest clinically?

Wisecracks.

1. What electrolytes abnormalities are often with hypomagnesemia?
2. How do you estimate the total body water?