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Issue 10:5

Ultrasound Case: Syncope in PE

Neil Wallace, MD1, Andrew Melendez, DO2, Lars K Beattie, MD3, Tina H Chen, MD4, David Fernandez, MD5, Amrita Vempati, MD6, Kelly Roszczynialski, MD, MS7, Stephanie Cohen, DO8 Stephanie Stapleton, MD9 and Tiffany Moadel, MD10

DOI: https://doi.org/10.21980/J8.52365Issue 10:5[mrp_rating_result]
By the end of the session, learners will be able to: 1) obtain and interpret the parasternal short-axis view of the heart to assess right ventricular size and function, 2) identify ultrasound findings suggestive of pulmonary embolism (PE) on cardiac short-axis view, including right ventricular dilation and septal bowing, 3) demonstrate appropriate probe selection and positioning to obtain optimal images of the heart and inferior vena cava (IVC), 4) evaluate the IVC using a subxiphoid or longitudinal view to assess distension and lack of respiratory collapse as supportive findings for elevated right heart pressures, 5) identify the anatomy of the neck vasculature, differentiate between the internal jugular vein and carotid artery, and select the appropriate puncture site, 6) describe ultrasound-guided central venous catheterization via the right internal jugular vein, using a sterile technique and real-time guidance
Current IssueCardiology/VascularProcedure & UltrasoundUltrasound

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.
Current IssueAbdominal/GastroenterologyPediatrics

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.
Current IssueInfectious 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.
Current IssueClinical 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.
Current IssueCardiology/Vascular

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.
Current IssueCertifying Exam CasesClinical Decision-MakingOphthalmology

Clinical Decision-Making Case: Non-Accidental Trauma

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

DOI: https://doi.org/10.21980/J8.53233 Issue 10:5[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 non-accidental trauma, 3) recognize potential physical exam findings in non-accidental trauma, 4) justify appropriate diagnostic studies based on clinical findings and current evidence on occult injury in suspected pediatric abuse, and 5) propose an appropriate disposition plan for patients with non-accidental trauma.
Current IssueCertifying Exam CasesClinical Decision-MakingPediatricsTrauma

Prioritization: Run This Board: Septic Shock, Acute Coronary Syndrome, Small Bowel Obstruction, and Penetrating Chest Trauma

Colleen Donovan, MD1, Nicole Novotny, MD2, Charles Lei, MD3, Alaa Aldalati, MBBS4, Andrew Melendez, DO5, Neil Wallace, MD6, Tiffany Moadel, MD7, Stephanie Stapleton, MD8 and Shagun Berry, DO9

DOI: https://doi.org/10.21980/J8.52355 Issue 10:5[mrp_rating_result]
By the end of this case learners will be able to: 1) Become familiar with format of a prioritization case (a component of the ABEM Certifying Exam), 2) Practice their ability to prioritize multiple patients and provide stabilizing care, 3) Consider changes in status/patient acuity/new cases as presented, 4) Understand how to utilize team resources appropriately.
Current IssueAbdominal/GastroenterologyCardiology/VascularCertifying Exam CasesClinical Decision-MakingInfectious DiseaseNeurologyOb/GynPediatricsPrioritizationTrauma
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