Medgeeks Clinical Review Podcast

So, today's podcast topic is not a common one, but definitely an emergency when it walks through the door. I actually recently admitted a patient with tumor lysis syndrome to the ICU. This was a very interesting case because it was spontaneous and not following chemotherapy treatment. So, I thought it would be appropriate to touch on this and break the case down in today's podcast. - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

As I pick up more per diem shifts in the ER, I've been seeing more and more complaints of the dreaded vaginal bleeding. At first, I avoided these patients as much as I could, because this isn't your every day complaint in the ICU. I had no idea how to approach these patients - I mean the last time I did a speculum exam was when I was a student. So, I challenged myself to see more of these patients so that I could develop a good diagnostic algorithm and management plan. So now I wouldn't say I'm a pro, but at least I know the right history questions to ask, the correct exams to perform, and the diagnostics to order as to not miss any life threatening problems. Today, I want to discuss the approach to the vaginal bleeding patient: What's normal bleeding? What are the red flags for emergencies you don't want to miss? What are the common causes? What diagnostics are we ordering? Let's get into today's podcast! - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

Lately, I've been seeing a ton of patient's coming into the ER with a chief complaint of syncope. Today, I want to discuss an approach to the syncopal patient. I also want to get into: Identifying the red flag emergencies Common causes of syncope What diagnostics need to be ordered Today, we have a 75 year old female with a past medical history of hypertension, hyperlipidemia, aortic stenosis, and diabetes. She comes in with a chief complaint of passing out suddenly as she was walking to the bathroom. She fell to the ground. But, luckily her son was there to help her before she did more damage. This was followed by immediate recover to her mental status baseline. Her son noticed she was in a normal state of healthy prior. No other associated symptoms. Today, let's get into how we would approach this patient. - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

Today, we're going to discuss the last topic of the toxicology series and that's going to be serotonin syndrome. We have a 32 year old male with a past medical history of depression who presents with an intentional overdose of Zoloft. Per the family, the patient was found in his bedroom acting abnormal, and an empty bottle of Zoloft was found on the floor. His last known normal was when he got home at 3pm, which was about 4 hours prior to arriving to the ER. Vitals: 103.9 F, 130 HR, 110/78, and 96% O2 RA. On exam he was agitated and irritable. He was flushed and sweaty with dilated pupils. He also had this inducible ankle clonus along with hyperreflexia of the lower extremities. Serotonin Syndrome can be fatal, therefore you never want to miss this, and this should always be on the differential when a patient presents with altered mental status, agitation, and/or with some neuromuscular abnormality. So, let's dive in to todays lecture! - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

Today, we're going to discuss anticholinergic toxicity. This is an important one as there are a ton of medications out there that have anticholinergic properties. We have a 75 year old female with a past medical history of Parkinsons, COPD, hypertension, and hyperlipidemia. She presents from a skilled nursing facility with altered mental status. Per the SNF, the patients baseline is alert and oriented x4 but does need assistance with ADLs. This morning the patient had intermittent agitation and was disoriented to self, place, and time. Patient had a temp of 102.3, HR 120, BP 130/89, RR 16, and 98% O@ RA. Of note, the patient has not urinated in over 12 hours. Per staff, she was seen yesterday for a low back musculoskeletal strain and was given flexeril and ibuprofen. Let's finish walking through this case together and discuss anticholinergic toxicity. - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

We have an 18 year old male with a past medical history of depression and anxiety who presents with remorse following an intentional ingestion of anything he could find in his parents medicine cabinet. He believes he took about a handful of tylenol tablets and thinks they were about 10 pills of 500 mg extended release tablets. It's the most commonly used fever reducing and pain control agent on the market. The most common cause of liver injury is drug induced, and half the cases, are due to Tylenol. This is why it's so important to know what to how to identify and manage these patients. So, let's dive in on learning about Tylenol overdose. - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

Over the next few weeks, I want to do a mini toxicology series. With the amount of new drugs and the amount of overdoses which are occurring, I think it's important for providers to know... The clinical presentation Diagnosis Differential Diagnosis Workup Management ...for these critical patients. Today, we'll be discussing the acute opioid overdose. We'll go over a case, break it down by intro, etiology, clinical presentation, workup, diagnosis, differentials, and management. So, let's dive in! - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

We have a 32 year old male with a past medical history of ETOH abuse (1 pint of vodka daily), ETOH related seizures, and hypertension. He presents with a complaint of severe epigastric pain and tenderness which started about a day ago and has progressively worsened over the day. The patient said he attempted to eat and drink this morning, but became nauseous and had one episode of non-bloody vomiting. The patient's last alcoholic drink was the night prior. He has no new medications. Vitals: 101.1F, HR 110, BP 89/68, 98% O2 sat RA. On exam, there is significant epigastric tenderness. But, no rebound or gaurding or peritoneal signs. Labs: WBC 15.4, H/H 15.7/43.5, platelets 188, BUN:Cr 10:1, Lipase is 2,806, and lactate of 10.3 Electrolytes, bilirubin, LFT, triglycerides normal. Today, we'll be breaking down acute pancreatitis. - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

Today, we have a 35 year old African American female with a past medical history of hypertension, who presents to the emergency department. He has a two week history of a viral upper respiratory symptoms, including a low grade fever, cough, nasal congestion, rhinorrhea, sore throat, decreased oral intake - followed by a persistent nose bleed. The nose bleed began over the last couple days and isn't stopping despite persistent pressure. And over the last 24 hours, she had a change in her mental status per her family. Her exam was unremarkable. Her vitals: 100.2 F, HR 90s, BP 145/82, and 98% O2 RA. Initial labs revealed: WBC: 18,000 H/H: 9/27 Platelets: 7,000 Creatinine: 1.4 Total bilirubin: 3 LDH: 1,500 Normal fibrinogen, D-dimer, PT, INR Peripheral smear: moderate schistocytes What's your diagnosis? Well, at this point, we are thinking Thrombotic thrombocytopenic purpura (TTP). Today, we are going to break this disease down for you. - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

Today, I want to talk about a specific topic, that I've seen about 5 times total in my career: Ace inhibitor induced angioedema The first question we should ask is, why do we care (aside from it being fatal)? Well, many patient's have hypertension, and many of them are placed on an ACE inhibitor. This makes ACE inhibitors the number one cause of drug induced angioedema in the United States. The most important thing to remember is the pathophysiology. Today, we'll do a quick review of... The pathophysiology behind why this occurs Why steroids and antihistamines will NOT help in this situation How our patient will present How long after an ACE is started will angioedema present? Diagnosing ACE induced angioedema Treating and managing your patient - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

As you start your shift, your first patient comes in with a chief complaint of headache. A 38 year old female comes in with a two day history of headache. She describes 8/10 pain on the left side of her head and is pulsating in quality. She denies any radiation and states the pain started while she was at work and continued to worsen. She took Motrin with minimal improvement. As soon as she got off work, the patient went home, and locked herself in a dark room - which helped. She has had headaches in the past, but this was a lot worse, which prompted her visit today. What is your diagnosis? To me, this sounds very much like a migraine.... In today's podcast, we'll touch on: Today, we'll touch on: Common and Classic Migraines + the difference between the two Signs and symptoms you don't want to miss aka red flags Dangerous differentials Who needs imaging? Treating acute migraine in the ED setting - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

This week, I want to do a quick rapid review of OSA (obstructive sleep apnea). It's a topic on the blueprint and one you should know about, because it puts patient's at risk for many complications. OSA is one of the most common sleep disorders and occurs due to decreased airflow through the upper airway due to soft tissue collapse. This occurs during sleep and leads to derangement of the oxygen-carbon dioxide exchange. Today we'll touch on: OSA Etiology and Risk factors Signs and Symptoms Diagnostic Testing Management We'll cover it all in just 5 short minutes. - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

Sepsis is an ever changing syndrome that has evolving definitions, scoring systems, and management. You might have heard about the surviving sepsis campaign. It's a joint collaboration between the Society of Critical Care Medicine and the European Society of Critical Care Medicine, which offers evidence based guidelines aimed at reducing sepsis related mortality and morbidity. Guidelines have been published 4 times now, with the 5th being in progress as we speak. Each edition has evolved, with the most recent being published in 2016. Today, I want to go over: Defining sepsis Finding the source Labs and imaging Management (antibiotics, fluids, etc) - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

Today, I'd like to talk about pulmonary hypertension. Most find this quite dull and boring. But, I find this topic interesting, and actually wrote a PA school paper on the topic. Before you skip this podcast, reconsider... ...I mean this topic is on the boards. Can you really say you know all the groups of pulmonary hypertension without looking them up? If not, then let's dive right in! We'll cover everything you need to know in 10 minutes. - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

The next patient on your list is a 35 year old male with a past medical history of IV drug and alcohol abuse. He's been sober for the last 7 years. He presents to the ER after a mechanical fall at home. The nursing triage notes states the patient was in his normal state of health, until about two days prior. He may have hit his head, but is unsure. The patient had a loss of consciousness. No neurological deficits. The day after his fall, he's experienced decreased urine output, despite increasing his water intake. The urine that was seen was noted to be brown. Labs were notable for BUN of 63 mg/dL Creatinine of 8 mg/dl. His last creatinine from a wellness visit was .8 mg/dl. Potassium 6.8 mEq/L. EKG is normal sinus rhythm. CK: 40,000 AST: 1066 ALT: 450 Urine analysis was positive for blood, but negative for RBCs. What would you do next? We'll walk you every step of the way! - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

Today, I want to review the evaluation and management of an acute COPD exacerbation. We have a 65 year old obese male who's a former smoker of 30 years (1 pack/day), but quit 5 years ago. He has a past medical history of COPD on 3L nasal canula, coronary artery disease, GERD, and type 2 DM. He's presenting with a 3 day history of subjective fever, increasing cough, increasing sputum production, and shortness of breath. On exam, he has bilateral wheezing. First let's treat the vitals: fever = tylenol tachycardia = EKG and former EKG hypoxia = high flow oxygen first line Now, that we've got the base down, we can start to manage the underlying cause: COPD exacerbation. I'll walk you through every step of the way in today's podcast. - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

Last week, we reviewed the different types of anticoagulation medications. Today, I want to review what to do when things go bad aka what are the reversal agents. There are 4 basic questions you should consider when thinking about anticoagulation reversal: Is the patient actively bleeding aka do I have to take action immediately? What anticoagulant is the patient on? When was their last dose? What doest the patient need the reversal for? i.e. life threatening bleed, emergent surgical procedure, etc. Let's dive right in! - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

Today, we're going to change gears. No case today and no systematic review. Instead, I want to review anticoagulation pharmacology...any medication that inhibits one or more steps of that coagulation cascade. We're going to review the new and old agents, including: Mechanism of action Indications Precautions Adverse effects Monitoring Dosing We'll also quickly review and simplify the intrinsic and extrinsic pathways. Next week, we'll touch on what to do when things get ugly and need to reverse these medications. - Subscribe to our YouTube here: http://www.youtube.com/subscription_center?add_user=medgeeks - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

I was doing some moonlighting the other week, and I had a textbook case walk through the door. However, it's a case that doesn't walk through the door all too often. I had a 63 year old male with a history of hypertension and type 2 DM who presented with sore throat x 5 days. He denies shortness of breath and chest pain. Vitals revealed normal temperature, HR 95, BP 145/80, and O2 sat 98% RA. At first, I was thinking this is likely a simple URI and was ready to give tylenol for pain coupled with a prescription for rest and fluids. As I walked in to greet the patient, I noticed there was clearly something wrong. He responded with a muffled voice as if he had a potato in his mouth. So I did my exam... ...I'm excited to share this case with everyone and I hope you enjoy! - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

It's that time of year ago and our little viral friend is quickly gracing us with it's presence. As of November 2nd, the CDC informed the community that influenza activity is low, however there have been small increases of activity seen over the prior week. So, it's coming... The three main strains seen are influenza A H1N1, influenza A H3N2, and influenza B. We'll do a quick review in just 5 minutes. Nothing but the facts today. - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

Hyperparathyroidism is one of those topics that is confusing, as it has primary, secondary, or tertiary causes. There are PTH, phosphate, calcium, and vitamin D levels. To be honest, it can get confusing. But, if you can understand the pathophysiology behind it all, then it will help you understand the labs and will help you come to the diagnosis. So, let's dive right in! - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

Today, we're going to do a quick systematic review of hyponatremia. If you're one of the few who know all the causes and correlating serum osmolality, urine osmolality, urine sodium values, and corresponding treatments - then this podcast is not for you lol. But, for those who struggle with hyponatremia, like I do at times, then have a listen as I break this down this complicated topic for you. After this podcast, you'll feel a lot more comfortable when a patient comes in with hyponatremia. - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

It's Monday morning and your first patient on your schedule comes in with one day of shortness of breath. The MA checks the vitals and says, "the patient's blood pressure is a little high at 220/110". The patient is a 55 year old male with a history of hypertension, hyperlipidemia, and heart failure with a preserved EF. So, what would be your next step? Today, we're going to talk hypertensive urgency and the management of this patient. - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

Today, we are going to do a quick systematic review of lymphomas: Hodgkin and non-Hodgkin lymphomas. I'm pretty sure after school, all I knew about this topic was that reed sternberg cells were associated with Hodgkin lymphoma. Maybe you're in the same boat. But, hopefully after todays podcast, you'll feel much more comfortable with this. - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This video should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

One of the most common issues I face are patients who have pain, anxiety, agitation, and delirium; sometimes all of them at once. Let's say we have a 75 year old female patient with a past medical history of dementia, chronic back pain with radiculopathy, CAD status post CABG, heart failure with a reduced EF, and ESRD on hemodialysis. She's on opiates, as well as on a neuropathic pain medication. The patient was brought into the ICU for septic shock due to UTI. She required pressors and also has acute decompensated CHF and acute on chronic renal failure due to the infection. Today we are going to discuss the pharmacology of medications used for pain, anxiety, agitation, and delirium. We'll touch on: Fentanyl Dilaudid Morphine Propofol Dexmedetomidine Benzodiazepines Haloperidol Quetiapine - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This video should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

Lets talk about the approach to the patient that presents to the hospital with altered mental status. This is a very common presentation that I see often - whether I'm in the emergency room, step down, or ICU. The etiologies can be endless. But, the goal after today's podcast, is to arm you with an algorithm to narrow in on that etiology. Enjoy! - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This video should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

You're asked to see a 22 year old female with a past medical history of asthma who presents to the emergency room with increasing shortness of breath, chest tightness, and wheezing. Over the past 24 hours she's been non-responsive to her home nebulizer treatment every 4 hours. A quick chart review allows you to see the patient has required ICU admission and mechanical ventilation last year due to an asthma exacerbation. As you walk into the room, you notice the patient can only speak one word at a time before taking deep breaths. She's in respiratory distress with an O2 sat of 88% on 2L NC. What would you do next? Today, we'll show you the next best steps! - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This video should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

Last week we presented a patient presenting with signs and symptoms of a PE and CTA confirmed saddle pulmonary embolism. So, now the questions is, what type of PE is this? Massive Submassive Non-massive (low risk) It's important we separate patients into different categories, because each category will have different adverse outcomes, and more importantly, differences in mortality risk. Therefore, if we can group these patients into a category, then this is the first step in identifying the best course of action. Today, we'll walk you through this every step of the way! - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This video should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

As you're working in the emergency room, you're asked to see a 62 year old female. She has a past medical history significant for morbid obesity (BMI 43). She fell three weeks ago and fractured her right tibia, which required a cast, and has been not been mobile since. She developed shortness of breath two weeks ago which has worsened to the point where she can't even put her clothes on without becoming symptomatic. Her right leg has also become increasingly swollen and painful. She denies fever, syncope, cough, hemoptysis, or chest pain. Vitals:BP: 132/84, Pulse: 118 bpm, Temp: 98.6 F, O2 sats: 86% on room air. 3L nasal canula was required to keep her sats at 96%. On todays podcast, Zach is going to walk you through this patient case presentation. - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

Today, we'll be introducing Katelyn Reeve to the team who will be starting her emergency medicine fellowship November 2018. Prior to PA school she played D1 soccer at Clemson University, was elected as captain for 2 years, and ended her time there as in the Academic Hall of Fame as an All-American. She then attended the Medical University of South Carolina (MUSC) in Charleston, SC and graduated in 2018 with a 3.99 GPA. Katelyn will be sharing her journey as she starts and goes through her emergency medicine fellowship - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This video should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

Prior to PA school, Zach was a clinical research coordinator at Mass General Hospital. He was lucky enough to work with some of the worlds leading researchers in cardiac imaging. One thing he learned was how to approach a medical paper... This skill is usually overlooked and most simply read the abstract of the paper. But, there's a lot more that we need to know, as research drives medicine. It's also your duty to stay uptodate to provide the most current evidence based medicine. After todays podcast, you'll be a pro at picking up a paper, approach it, dissect it, and get the most bang for your buck so you can start using what you learned in practice the next day. - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

This is the final lecture in our ABG mini series. Today, we're going to finish it all off with metabolic alkalosis. This has the potential for some really bad complications: seizures, arrhythmias, electrolyte abnormalities, and death. The patients with alkalosis should definitely scare you most. So, let's dive right in! - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

This acid base disorder requires multiple steps! So, make sure to pay close attention to this one. But, what are common metabolic acidosis disorders? Well, everyone jumps to MUDPILES. The first step, however, is to determine if there's an increased anion gap or not. Remember, the body already has a normal anion gap (difference between anions and cations). Clinical pearl for all you Medgeeks: the anion gap is affected by albumin and this is the most abundant unmeasured anion in the body.Therefore, if albumin is low, then the normal anion gap in the body is lowered. For everyone 1 unit decrease in the albumin from 4, then the normal anion gap drops by 2.5. If there's an increased anion gap - then we think MUDPILES So let's jump right in to metabolic acidosis! - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

Today, we'll be going over part 2 of 4 of the acid base disorders. As a recap, what is normal? Well, a normal pH is 7.35 - 7.45 If the pH is If the pH is >7.45 then we have alkalemia. A normal bicarbonate is 22-26 and a normal pCO2 is 35-45. In today's podcast we are going to tackle respiratory acidosis, partial vs complete compensation, and we'll show you what to look for to see if there is a co-existing acid/base disorder. - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

Over the next 4 weeks we will be going over ABGs. We're going to break them down into 4 parts, as they all require different approaches. This will be our schedule for the next few weeks: Respiratory acidosis Respiratory alkalosis Metabolic acidosis Metabolic alkalosis Today, we will be talking respiratory acidosis. Zach sees acid/base disorders on a daily basis and does an amazing job teaching this frustrating topic! - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

Today, we're going to talk about the patient, who makes you want to go home and have your own drink. You get a page from the ER about a new admission. It's a 35 year old male patient with a past medical history of heavy alcohol abuse - he presents to the hospital asking for detox. For every ETOH patient that walks through the door, Zach normally has a set of questions he likes to ask, depending on the patient's cooperation... 1. How long have you been drinking for? 2. How much do you drink on a daily basis? Is it daily or do you take breaks? 3. What is your drink of choice? 4. When was your last drink? 5. Have you ever been hospitalized for drinking? 6. Have you ever had ETOH withdrawal, seizures, or delirium tremens? 7. Have you ever been intubated in the ER due to alcohol abuse? 8. Is there any other drug use? 9. Why did you decide to come in today? These questions will help you triage the patient to see what level of care they will require. Today, you'll learn all about alcohol withdrawal syndrome. - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

In last weeks episode, we discussed the differences between DKA and HHS. Today, we'll be sharing how to manage these two diseases. If you missed last weeks episode, you can listen to that here: https://medgeeks.co/podcast/ We had that 35 year old female with type 1 DM on insulin complaining of burning with urination, followed by a few days of nausea, vomiting, abdominal pain, and poor PO intake. Labs revealed DKA: glucose 480, HA1c 10.5%, positive urine/serum ketones, creatinine 1.6, and anion gap of 25. ABG showed ph of 7.25, PCO2 of 28, bicarb of 12, and O2 of 90 on room air. This is a metabolic acidosis with respiratory compensation. (We'll also show you a shortcut on how to calculate the expected compensation). Sodium was 136. UA was positive for infection. Vitals: BP 83/45 - MAP of 58, HR 110, 100.8 F. Management can be grouped into 3 categories: 1. fluids and electrolytes 2. insulin 3. monitor Today, we'll break this all down for you. Enjoy! - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

Today, we're going to talk about the evaluation of your diabetic patient who walks into your clinical with a glucose which is unable to be read (>500). A 35 year old female with type 1 DM on insulin arrives to the ER for evaluation after being referred by her PCP. The patient complains of burning with urination x3 days, followed by nausea, vomiting, and abdominal pain with poor PO intake. Because she hasn't been eating regularly, she didn't take her insulin last night. When a patient comes in with this presentation, we need to be thinking DKA (diabetic ketoacidosis) or HHS (hyperosmolar hyperglycemic state). Today, Zach will run through this patient with you so that you can decipher between the two disease processes. - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

​As you start to review your patients - you get your first page. So, you call stat, and on the other end, you hear a frantic nurse saying, "Bed 45. Heart rate 150s with an irregular rhythm." Your first thought should be AFIB with RVR until proven otherwise. Today, Zach will give you the run down on what to do with these patients... Click here to learn about the acute AFIB patient Zach drops a ton of practical clinical pearls in this podcast. - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

​You're on the rapid response team and are called over to a patient presenting with hypotension. Per nursing, the patient is a 58 year old male with a PMH of: ​ETOH abuse (1 pint of vodka daily) Cirrhosis While in the room, the patient vomits a large amount of bright red blood, followed by a drop in the systolic blood pressure to the 70s.​ The patient looks lethargic, unresponsive to verbal stimuli or a sternal rub. You see fresh blood in the oropharynx. What should you do next? We'll walk you through and answer that for you in today's podcast. p.s. this is part 3 of 3 for the GI bleed lecture series. Next week, we'll tackle a brand new topic. - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

Today, we have a 60 year old male patient, with a past medical history of: Osteoarthritis COPD Atrial fibrillation Hypertension Hyperlipidemia Diverticulosis Rectal cancer Chief complaint: 1 day rectal bleeding (episodes every hour) causing them to spend the entire day in the bathroom. The patient states he's had a similar episode like this years ago. Before we see the patient, we should be asking... What is the trend of our patient blood pressure since arrival? Is the patient actively bleeding? Are they symptomatic (weak, dizzy, lightheaded, etc)? What is the access? We're going to walk through this patient's case together over on our podcast. - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

Over the next three weeks we are going to dive into the GI bleed patient. We're going to divide these lectures into: upper GI bleed (above the ligament of treitz), lower GI bleed (below the ligament of treitz), and the scary liver patient who has a GI bleed. Today, let's work through an upper GI bleed case presentation as we touch on the background, evaluation, and management of the patient. Today we're going to be discussing a 75 year male patient presenting with a chief complaint of 3 days of black stool. He came into the ED because he had a dark bowel movement and dizziness. Let's walk through this case together so you feel confident evaluating the upper GI bleed patient. - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

A 65 year old female presents to your ER with difficulty breathing over the past 3 days, despite increasing her home oxygen tank to 3 liters. Her husband called 9-11 because she wasn't really acting herself. EMS arrived and found her sats in the 70s and put her on a non-rebreather mask and had an improvement in her sats to the low 90s. They also reported some wheezing on exam, so they gave her one duoneb prior to arrival. Per EMS she has a past medical history of COPD (on 3 liters around the clock), CHF with an EF of 40%, hypertension, hyperlipidemia, and type II DM. So, you walk into the hospital room and the first thing you notice is that the patient appears to be in respiratory distress. Shes' wearing a nasal canula which is set to 5 liters. She's breathing fast (belly breathing), her sternocleidomastoids are going to town, she has accessory muscle use. Her sats are at 82% with good wave form on the monitor. Heart rate is in the 80s. Systolic BP of 150. She's able to tell you her name and her story - but she's definitely having difficulty speaking due to the respiratory distress. You listen to her lungs and she's wheezing, but also hear some crackles at the base. What would you do? Today, we'll show you what to do next, so you don't freeze up should this patient ever walk into your hospital... - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

I just got off a long stretch of working 7 days in a row in the ER. Every time I finish a shift I like to replay in my mind every patient I saw and I ask myself: 1. is there anything I could have done better? 2. were there any gaps in knowledge regarding any disease processes? 3. was I able to make a positive impact in my patients life? Working in emergency medicine, we often feel like we make the most impact when working on a code, and we are able to bring a patient back and/or taking care of a crashing patient. Well, this week I was reminded we can drastically improve the quality of there life. Today, I want to share my most interesting cases of the week. Case 1: 34 year old male c/o chest pain after cocaine use Case 2: 55 year old female complaining of cough following "failed" treatment for pneumonia Case 3: 58 year old male c/o SOB with a pulsating uvula Case 4: 24 year old female 5 weeks GA c/o vaginal bleeding and lower abdominal pain - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks

​Today, I want to share why I love being a PA. Specifically, an emergency medicine physician assistant. First off, I love the fact you can practice in a specific field for a given duration, and later transition to another down the road. As nice as this is for most, I don't see myself doing this. Reason being is I have such a love for emergency medicine! With that said, I do see myself working in trauma to hone my schools further. I recently switched hospitals, where I've been allowed to handle the more complicated patients (codes, intubations, etc). And let me tell you - I have learned a ton! I hope you enjoy this inside loo as to why I love being an emergency medicine physician assistant. - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

First off, what is tetanus and clostridium tetani? Who's at risk? Is this fatal? We'll also explain who needs to be vaccinated and teach you how to handle clean and dirty wounds. We know this can get confusing - so we're going to make this as simple as possible! - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This video should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

Today, we're going to discuss Nurse Maid Elbow. Specifically, we'll review: The anatomy of the elbow How this injury occurs How the patient presents Imaging studies to consider Treatment A case study of a patient he had presenting to the ER - I once had a mother who came into the ER with her two-year old son extremely upset with herself and very emotional. She was upset because she had just put her son in day care and gone back to work recently because she said money was really tight And that, something like this wouldn't have happened if she were still the one taking care of her son. The mother wasn't exactly sure what happened, but she was told that while at daycare someone stepped on her son's hand and then he wouldn't use his whole arm since. Now the mother could not believe that this is what actually happened and she sincerely asked me if I thought that someone could have physically assaulted her child. So, we'll go through this case in more detail. - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This video should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

There are certain things in medicine which simply can't be taught by reading a textbook. Not everything follows an algorithm. About one year ago I had an 80 year old patient who kept complaining of nausea and abdominal pain after having a cholecystectomy. The surgeons kept telling her this was normal following this type of procedure and prescribed Zofran. Well, she eventually came into my ER and she didn't look to good. She became septic. We followed the septic protocol - but she ended up dying. Today, I want to share a very important lesson I learned... - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

Today, I'm going to be sharing my day with you in the emergency department. I had a patient coming in with isolated third cranial nerve palsy. I wasn't quite sure how to approach this and so we got a consult. Something clinicians struggle with is knowing when to call for help. They feel pressured to handle everything which comes there way - for fear of looking "stupid". But, as you'll see in today's video, that shouldn't be the case. If you want to see more videos like this - let us know in the comments below! - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast, video, or blog.

Todays lecture, builds on last weeks video, after discussing those at high risk for complications of the flue. Today, you'll learn: - about post influenza asthenia - how to remember possible complications using the mnemonic "crocs" - signs and symptoms of complications to help diagnose - Todays lecture, builds on last weeks video, after discussing those at high risk for complications of the flue. Today, you'll learn: - about post influenza asthenia - how to remember possible complications using the mnemonic "crocs" - signs and symptoms of complications to help diagnose - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level. You can learn more about our mentorship opportunities here: https://www.medgeeksmentorship.co/opportunities or schedule a time to chat with our advisors here: https://www.medgeeksmentorship.co/application - Learn more about what we do here https://medgeeks.co/about-us - Check out our free Facebook group, where we share daily clinical pearls, advice, and practice changing updates: https://www.facebook.com/groups/medgeeks - This video should not be used in any legal capacity whatsoever, including but not limited to establishing standard of care in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast or blog.