Archives
Iron Overdose
James Roy Waymack, MD*, Marit Tweet, MD* and Richard Austin, MD*
By the end of this oral boards case, learners will: 1) demonstrate evaluation of a patient presenting with toxic ingestion, including obtaining pertinent history, 2) review the signs and symptoms of the different presenting phases of acute iron ingestion, and 3) demonstrate appropriate treatment of iron overdose, namely, iron chelation therapy with deferoxamine.
Tubo-Ovarian Abscess
Patrick G Meloy, MD*, Amit Bhambri, MD^ and Megan C Henn, MD*
We aim to teach the presentation and management of cardiovascular emergencies through the creation of a flipped classroom design. This unique, innovative curriculum utilizes resources chosen by education faculty and resident learners, study questions, real-life experiences, and small group discussions in place of traditional lectures. In doing so, a goal of the curriculum is to encourage self-directed learning, improve understanding and knowledge retention, and improve the educational experience of our residents.
Bell’s Palsy
DOI: https://doi.org/10.21980/J89G9M Issue 3:2[mrp_rating_result]At the end of this oral boards session, examinees will: 1) Demonstrate ability to perform a thorough neurologic examination including full cranial nerve exam, National Institutes of Health (NIH) stroke scale assessment, strength and sensation and reflex testing, pronator drift, speech repetition. 2) Differentiate between Bell’s Palsy and acute stroke with facial paralysis. 3) List appropriate laboratory testing for a case of peripheral facial nerve paralysis (basic metabolic panel [BMP]; complete blood count [CBC]; coagulation studies if considering lumbar puncture; human immunodeficiency virus (HIV) test if high-risk by history, or if bilateral; Lyme titer if in endemic area, or if bilateral). 4) Select appropriate treatments (steroids, eye lubricant and patch, PCP referral) for peripheral facial nerve paralysis.
Placenta Previa
Angela Irene Carrick, DO*
By the end of this oral boards case, the learner will be able to: 1. List the potential causes of vaginal bleeding in pregnancy after 20 weeks including placental abruption, placenta previa and vasa previa. 2. Describe the bedside stabilization and evaluation in a pregnant patient with vaginal bleeding after 20 weeks. a) Stabilize the mother (patient) including placing two large bore intravenous (IV) lines, administer an IV fluid bolus, obtaining complete blood count (CBC), coagulation studies, and type & cross matching blood. b) Transvaginal ultrasound to determine the placental location. c) Sterile speculum examination. A digital or speculum pelvic examination should NOT be performed until a transvaginal ultrasound is performed to determine placental location. The resident should understand that performing a digital or speculum exam in a patient with placenta previa or vasa previa can cause or exacerbate hemorrhage. If these two conditions are not present on ultrasound, then a sterile speculum exam may be performed to further examine the bleeding. 3. Contrast the typical presentation of placenta previa with that of placental abruption. a) Placenta Previa usually causes painless vaginal bleeding. Part of the placenta is located near or over the internal cervical orifice. b) Placental Abruption usually causes painful vaginal bleeding. There is premature separation of the placenta from the uterine lining. 4) Describe the appropriate disposition of a patient with a pregnancy over 20 weeks with vaginal bleeding. After initial workup and stabilization these women are usually admitted for fetal monitoring, observation and consultation by the obstetrician (OB/gyn).
Neutropenic Fever
Shannon Toohey, MD, MA*
Neutropenia is a common oncologic emergency, and it frequently develops as a result of myelosuppression from chemotherapy. Neutropenia is defined as absolute neutrophil count (ANC) <1000/mm3, with severe neutropenia being defined as ANC<500/mm3. Patients with fever and neutropenia should be presumed to have infectious etiology and started on antibiotics immediately. The 48-hour mortality associated with an untreated infection is 20%-50%.
Carbon Monoxide Poisoning
Alisa Wray, MD*
By completing this oral board case learners will 1) evaluate a patient with altered mental status and discuss the differential diagnosis of a patient with altered mental status and weakness; 2) recognize the signs and symptoms of carbon monoxide poisoning; 3) manage treatment of a patient with carbon monoxide poisoning