Archives

Acute Chest Syndrome

Patrick Meloy, MD*, Daniel R Rutz, MD^ and Amit Bhambri, MD†

DOI: https://doi.org/10.21980/J80S8J Issue 8:1 No ratings yet.
At the end of this oral board session, examinees will: 1) demonstrate the ability to obtain a complete medical history; 2) demonstrate the ability to perform a detailed physical examination in a patient with respiratory distress; 3) identify a patient with respiratory distress and hypoxia and manage appropriately (administer oxygen, place patient on monitor); 4) investigate the broad differential diagnoses which include acute chest syndrome, pneumonia, acute coronary syndrome, acute congestive heart failure, acute aortic dissection and acute pulmonary embolism; 5) list the appropriate laboratory and imaging studies to differentiate acute chest syndrome from other diagnoses (complete blood count, comprehensive metabolic panel, brain natriuretic peptide (BNP), lactic acid, procalcitonin, EKG, troponin level, d-dimer, chest radiograph); 6) identify a patient with acute chest syndrome and manage appropriately (administer intravenous pain medications, administer antibiotics after obtaining blood cultures, emergent consultation with hematology) and 7) provide appropriate disposition to the intensive care unit after consultation with hematology.
Cardiology/VascularCurrent IssueOral Boards

Acute Flaccid Myelitis

Dane Zappa, MD* and Linda L Herman, MD, FACEP^

DOI: https://doi.org/10.21980/J8MP9G Issue 7:3 No ratings yet.
At the end of this oral board session, examinees will: 1) demonstrate the ability to obtain a complete pediatric medical history; 2) demonstrate an appropriate exam on a pediatric patient including a neurological exam; 3) investigate the broad differential diagnoses for neuromuscular weakness in a pediatric patient; 4) order the appropriate evaluation studies including an MRI; 5) interpret the use of a negative inspiratory force in determining the need for intubation and level of care upon admission; and 6) demonstrate effective communication with parents and caregivers.
NeurologyOral Boards

3rd-Degree Atrioventricular Block

Patrick Meloy, MD*, Dan Rutz, MD^ and Amit Bhambri, MD†

DOI: https://doi.org/10.21980/J8NP9S Issue 7:2 No ratings yet.
At the end of this oral board session, examinees will: 1) demonstrate ability to obtain a complete medical history including detailed cardiac history, 2) demonstrate the ability to perform a detailed physical examination in a patient with cardiac complaints, 3) investigate the broad differential diagnoses which include acute coronary syndrome (ACS), electrolyte imbalances, pulmonary embolism, cerebrovascular accident, aortic dissection and arrhythmias, 4) obtain and interpret the cardiac monitor rhythm strip to identify complete heart block, 5) list the appropriate laboratory and imaging studies to differentiate arrhythmia from other diagnoses (complete blood count, comprehensive metabolic panel, magnesium level, EKG, troponin level, chest radiograph), 6) identify a patient with complete heart block and manage appropriately (administer IV atropine, attempt transcutaneous pacing, place a transvenous pacemaker, emergent consultation with interventional cardiology), 7) provide appropriate disposition to intensive care after consultation with interventional cardiologist.
Cardiology/VascularOral Boards

Thyroid Storm

Kathryn Ritter, MD* and Carmen Wolfe, MD*

DOI: https://doi.org/10.21980/J8RW71 Issue 5:4 No ratings yet.
At the end of this practice oral boards case, the learner will: 1) assess a patient with altered mental status in an oral boards format; 2) review appropriate laboratory testing and diagnostic imaging; 3) identify signs and symptoms of thyroid storm and 4) review appropriate pharmacologic therapies with the proper sequence and timing.
EndocrineOral Boards

Eclampsia

Patrick G Meloy, MD*, Megan C Henn, MD*, Daniel Rutz, MD^ and Amit Bhambri, MD†

DOI: https://doi.org/10.21980/J8M93D Issue 5:3 No ratings yet.
At the end of this oral boards session, examinees will: 1) Demonstrate ability to obtain a complete medical history including a detailed obstetric history. 2) Demonstrate the ability to perform a detailed physical examination in a postpartum female patient who presents with a seizure. 3) Investigate the broad differential diagnoses which include electrolyte imbalances, brain tumor, meningitis or encephalitis, hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome and eclampsia. 4) List the appropriate laboratory and imaging studies to differentiate eclampsia from other diagnoses (complete blood count, comprehensive metabolic panel, magnesium level, pregnancy testing, urinalysis, and computed tomography [CT] scan of the head). 5) Identify a postpartum eclampsia patient and manage appropriately (administer IV magnesium therapy, administer IV antihypertensive therapy, emergent consultation with an obstetrician). 6) Provide appropriate disposition to the intensive care unit after consulting with an obstetrician.
Ob/GynOral Boards

Tricyclic Antidepressant Overdose

Patrick G Meloy, MD*, Amit Bhambri, MD^ and Megan C Henn, MD*

DOI: https://doi.org/10.21980/J85W50Issue 4:3 No ratings yet.
At the end of this oral boards session, learners will be able to: 1) discuss the appropriate laboratory testing and workup for a patient with undifferentiated altered mental status, 2) discuss the importance of obtaining an ECG in a timely manner in order to investigate the broad differential of altered mental status, 3) identify the classic ECG findings of a patient with TCA overdose, 4) review the treatment of TCA overdose, 5) discuss the appropriate disposition of a patient with TCA overdose.
Oral BoardsToxicology

Iron Overdose

James Roy Waymack, MD*, Marit Tweet, MD* and Richard Austin, MD*

DOI: https://doi.org/10.21980/J8MD1P Issue 4:1 No ratings yet.
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.
Oral BoardsToxicology

Tubo-Ovarian Abscess

Patrick G Meloy, MD*, Amit Bhambri, MD^ and Megan C Henn, MD*

DOI: https://doi.org/10.21980/J8Q92ZIssue 3:4 No ratings yet.
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.
Ob/GynOral Boards

Bell’s Palsy

Patrick G Meloy, MD*, Todd A Taylor, MD*, Chris Dudley, MD* and Michelle D Lall, MD*

DOI: https://doi.org/10.21980/J89G9M Issue 3:2 No ratings yet.
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.
NeurologyOral Boards

Placenta Previa

Angela Irene Carrick, DO*

DOI: https://doi.org/10.21980/J8J911 Issue 2:4 No ratings yet.
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).
Ob/GynOral Boards