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Clinical Decision Making: Sickle Cell Crisis with Acute Chest Syndrome

Ryan Adkins, DO*, Aubrey Bethel, MD* and Sara Dimeo, MD*

DOI: https://doi.org/10.5070/M5.53173 Issue 11:4[mrp_rating_result]
By the end of this clinical decision-making case, learners will be able to: 1) demonstrate familiarity with a case, 2) identify focused historical and physical exam findings in ACS, 3) develop a differential diagnosis for chest pain in a sickle cell patient, 4) select and interpret appropriate diagnostic studies, 5) initiate ED management including oxygen, antibiotics, and pain control, 6) recognize when to consult hematology and consider transfusion, 7) appropriately disposition the patient and communicate a transition of care, and 8) explain the pathophysiology of ACS.
Current IssueCertifying Exam CasesClinical Decision-Making

Clinical Decision Making: Acute Ischemic Stroke with Large Vessel Occlusion

Jennifer Yee, DO, MAEd*, Christopher E San Miguel, MD, MEd*, Jennifer M Mitzman, MD*, Simiao Li-Sauerwine, MD, MSCR*, Geremiha Emerson, MD*, Cynthia Leung, MD, PhD*, Krystin N Miller, MD*, Kelsey H Jordan, PhD, MPH* and Sorabh Khandelwal, MD*

DOI: https://doi.org/10.5070/M5.60864 Issue 11:3[mrp_rating_result]
By the end of this clinical decision-making case, learners will be able to: 1) demonstrate familiarity with the CDM case format and case play, 2) describe important historical information to obtain when suspecting an acute stroke, 3) outline key diagnostic tests to rule out other causes of acute neurologic deficits, 4) outline acute management strategies for acute ischemic stroke, 5) propose an appropriate disposition plan for patients with an acute ischemic stroke.
Certifying Exam CasesClinical Decision-MakingNeurology

Clinical Decision-Making Case: Febrile Infant

Carrie Maupin, MD, MPH, MHPE*, Ambika Anand, MD, MEHP*, Grace Hickam, MD, MEHP* and Danielle Nesbit, DO*

DOI: https://doi.org/10.5070/M5.52290Issue 11:1[mrp_rating_result]
By the end of this CDM case, learners will be able to: 1) demonstrate familiarity with the CDM case format, 2) recognize the critical importance of fever in a neonate and initiate a thorough evaluation, 3) develop an appropriate differential diagnosis and understand the workup for febrile neonates, 4) identify and justify the appropriate diagnostic studies and interpret their findings in the context of a neonate with fever, 5) justify a treatment plan and understand the critical disposition of a neonate with fever.
Board ReviewCertifying Exam CasesClinical Decision-MakingInfectious DiseasePediatrics

Clinical Decision-Making Case: Intussusception

Brian Milman, MD* and Samuel Parnell, MD*

DOI: https://doi.org/10.21980/J8.52171 Issue 10:5[mrp_rating_result]
By the end of this mock oral boards session, learners will (1) demonstrate familiarity with the CDM case format and case play, (2) model a problem-based history and physical exam, (3) generate a differential diagnosis for pediatric abdominal pain, and (4) demonstrate the ability to manage intussusception.
Abdominal/GastroenterologyBoard ReviewCertifying Exam CasesClinical Decision-MakingPediatrics

Clinical Decision-Making Case: Pediatric Sexually Transmitted Infections and Consent

Emily Drone, MD*, Andrew Shedd, MD^, Leslie Rodriguez, RN, MSN† and Chinmay Patel, DO^

DOI: https://doi.org/10.21980/J8.52335 Issue 10:5[mrp_rating_result]
By the end of this case the learner will be able to: 1) demonstrate competency with the new ABEM Certifying Exam Clinical Decision-Making Case format, 2) manage a simulated pediatric care encounter that requires navigating the details of pediatric consent, 3) explain common exceptions to requiring parental consent in emergency situations according to established guidelines as well as state and local laws, 4) report increased comfort managing ethical dilemmas related to pediatric consent in the ED.
Certifying Exam CasesClinical Decision-MakingInfectious DiseaseOb/GynPediatrics

Clinical Decision-Making Case: Seizing the Diagnosis: Eclampsia

Samuel Parnell, MD*, Joshua Ginsburg, MD*, Brian Milman, MD* and Marshall Howell, MD*

DOI: https://doi.org/10.21980/J8.52338 Issue 10:5[mrp_rating_result]
By the end of this Mock Certifying Exam session, learners should be able to: 1) demonstrate familiarity with the Clinical Decision-Making case format and structure, 2) elicit relevant historical information and connect that information to the diagnosis of eclampsia, 3) describe and interpret physical exam findings and their significance in establishing a pertinent differential diagnosis, which includes eclampsia, 4) initiate appropriate diagnostic testing, interpret results accurately, and formulate a stabilization and treatment plan for a patient with eclamptic seizures, and 5) reassess the patient's condition, modify the management plan as needed, provide relevant anticipatory guidance for disposition, and articulate the clinical decision-making rationale at each stage of the encounter.
Board ReviewCertifying Exam CasesClinical Decision-MakingOb/Gyn

Clinical Decision-Making Case: Pulmonary Embolism

James H Lee, MD* and Linda Herman, MD*

DOI: https://doi.org/10.21980/J8.52339 Issue 10:5[mrp_rating_result]
By the end of the clinical decision-making case, the learner will: 1) gain familiarity with clinical decision-making (CDM) case format to be used in the new American Board of Emergency Medicine (ABEM) certification examination starting in 2026, 2) demonstrate the ability to obtain a focused history and physical examination and develop appropriate differential diagnoses for chest pain and dyspnea, 3) demonstrate understanding of clinical decisions rules to estimate the pre-test probability for pulmonary embolism and the application of rules to guide appropriate diagnostic testing, 4) recognize high clinical suspicion for pulmonary embolism and indication for empirical treatment, 5) recognize the unstable patient and provide appropriate hemodynamic and respiratory support, 6) understand indications for thrombolytic therapy or embolectomy in unstable pulmonary embolism, 7) demonstrate communication skills with patients and specialists across the health care spectrum, and 8) arrange appropriate disposition for the unstable patient with a pulmonary embolism.
Board ReviewCardiology/VascularCertifying Exam CasesClinical Decision-Making

Clinical Decision-Making Case: A Giant Headache

Mark Portman, MD* and Linda Herman, MD*

DOI: https://doi.org/10.21980/J8.52322 Issue 10:5[mrp_rating_result]
By the end of this clinical decision-making case, learners will be able to: 1) demonstrate increased knowledge pertaining to ABEM’s clinical decision-making case, 2) communicate the differential diagnosis of a new acute onset headache in patients over the age of 50 and the importance of giant cell arteritis in that differential, 3) acquire an appropriate history and physical exam in this clinical setting, 4) verbalize, interpret, and justify the appropriate diagnostic testing for this clinical case (at minimum CT head, complete blood count (CBC), basic metabolic panel (BMP), comprehensive metabolic panel (CMP), erythrocyte sedimentation rate (ESR), and 5) explain the appropriate treatment and disposition of a patient with temporal arteritis.
Board ReviewCertifying Exam CasesClinical Decision-MakingOphthalmology