Rank #1: CRACKCast E036 - Multiple Trauma
This episode covers Chapter 36 of Rosen's Emergency Medicine.Episode Overview:
- List indications for activation of a trauma team
- What is the general approach to a multi-trauma patient?
- List commonly missed trauma injuries
- ED thoracotomy indications and contraindication for blunt and penetrating trauma
- Describe the term permissive hypotension and when you would not use it
- What are 3 goals for out of hospital care of a trauma patient
Aug 15 2016
Rank #2: CRACKCast E037 - Trauma in Pregnancy
This episode covers Chapter 37 of Rosen's Emergency Medicine.With trauma in pregnancy we need to think about blunt vs. penetrating trauma. Many women do not know they are pregnant.
- What is the threshold for fetal viability and how can this be estimated clinically?
- List the expected physiologic changes during pregnancy.
- List 8 unique considerations in the management of the pregnant trauma patient.
- How is fetal distress detected?
- Discuss placental abruption including the pathophysiology, clinical findings, diagnostic modalities, management, and complications.
- List 2 potential uterine injuries
- What is a safe radiation dose in pregnancy? What diagnostic tests have the potential to exceed this dose?
- Describe early, variable, and late decelerations. What is the implication of each? What is one other indicator of fetal distress related to the FHR?
- How is feto-maternal hemorrhage diagnosed and managed?
- Describe specific management in the following conditions:
- What are indications for peri-mortem c-sections. Describe the procedure.
Aug 22 2016
Rank #3: CRACKCast E207 – Dizziness and Vertigo
- What is dizziness and what pathologies can cause it?
- Define vertigo and acute vestibular syndrome
- What three systems are involved in the maintenance of equilibrium and how many of these systems must be affected to cause vertigo?
- Trace the neuronal impulse from the vestibular apparatus to the muscle endplate
- Define nystagmus
- List five peripheral causes of vertigo (see Table 16.2)
- List five central causes of vertigo (see Table 16.2)
- Differentiate between central and peripheral vertigo based on history and clinical exam findings
- Describe the Dix Hallpike Test
- Outline your approach to the HINTS exam
- What is the Epley maneuver and what pathology does it treat?
- Describe the Barbecue Roll Test and what pathology does it treat?
- Outline your approach to managing the vertiginous patient
- What diagnoses cause both vertigo and hearing loss?
- What features of nystagmus suggest a central pathology?
- What is truncal ataxia and what typically causes it?
Nov 04 2019
Rank #4: CRACKCast E200 – Fever in the Adult Patient
- What structure controls body temperature and how does it go about controlling it?
- What are pyrogens and how are they classified?
- What is the difference between fever and hyperthermia?
- What is the role of PGE2 in fever and what medications can you give to combat its effects?
- List four factors that blunt the febrile response.
- What are the benefits and pitfalls of the febrile response?
- List five infectious and five non-infectious causes of fever. (see Box/Table 9.1)
- Describe your approach to the febrile patient. (see Figure 9.1/9.2)
- What is the most accurate temperature measurement site?
- How are heart rate and body temperature related?
- How are respiratory rate and body temperature related?
- How high must a fever be to necessitate rapid cooling interventions?
Apr 01 2019
Rank #5: CRACKCast E199 – Adult Resuscitation
- Describe your history and physical exam in the patient being actively resuscitated.
- Discuss the process of deterioration to cardiac arrest with respiratory failure and cardiac obstruction.
- List 6 aspects of optimal CPR.
- What medications have been shown to improve outcomes in cardiac arrest?
- List 8 differential diagnoses for PEA arrest (See Table 8.4)
- What is electromechanical dissociation (EMD) and how does it differ from pseudo electromechanical dissociation (pseudo EMD)?
- What is echo-guided life support (EGLS) and how is it used?
- Carotid or femoral pulse
- Arterial relaxation (diastolic) pressure
- What are your targets during CPR for the following metrics? (See Table 8.3)
- What is cough CPR and when should it be used?
- What is the only antidysrhythmic shown to improve rates of VF conversion to a perfusing rhythm?
- What is the minimum coronary perfusion pressure (CPP) is needed to achieve return of spontaneous circulation (ROSC)?
- What is the triad of cardiac arrest?
Mar 04 2019
Rank #6: CRACKCast E125 – Electrolyte Disorders
- What are the five most common causes of hyperkalemia?
Describe the ECG features seen with hyperkalemia. List at least 5.
How is hyperkalemia managed? How does each intervention work, and how long do the effects typically last?
What are the five most common causes of hypokalemia?
Describe the ECG features seen with hypokalemia. List at least 4.
How is hypokalemia managed?
What are the three main types of hypernatremia? Give 3 examples of each.
List four central and four nephrogenic causes of diabetes insipidus.
What are the four broad categories of hyponatremia?
Give an example of two clinical conditions for each: hypovolemic, euvolemic and hypervolemic hyponatremia.
What are the three most common causes of SIADH?
Describe the management of hyponatremia in the following patients:
Euvolemic with acute hyponatremia
Hypovolemic with chronic hyponatremia
Hypovolemic with acute hyponatremia
What are the five most common causes of hypercalcemia?
What are the five most common symptomatic causes of hypocalcemia seen in the emergency department?
What ECG features are seen in hypercalcemia vs. hypocalcemia? How is each managed?
What are the five most common causes of hypermagnesemia?
List five clinical manifestations of hypermagnesemia.
List five common causes of hypomagnesemia.
What are the five most common causes of hyperphosphatemia?
What are the five most common causes of hypophosphatemia in the ED? How do they manifest clinically?
- What electrolytes abnormalities are often with hypomagnesemia?
- How do you estimate the total body water?
Nov 09 2017
Rank #7: CRACKCast E149 - ASA & NSAIDS
This episode of CRACKCast covers Rosen's Chapter 149, Aspirin and Nonsteroidal agents. You will become well-versed in the presentation of Salicylism and how to manage it. The episode also touches on NSAID overdose, with rare severe complications.
Feb 01 2018
Rank #8: CRACKCast E173 – Infectious Diarrheal Disease and Dehydration
1) What are three pathophysiologic types of diarrhea? Give an example of a cause for each.
2) List 6 common causes of childhood infectious diarrhea in developed countries.
3) List 5 important differential diagnoses of diarrhea in children.
4) List 5 important differential diagnoses of vomiting in children.
5) When should you initiate a medical evaluation of children with acute diarrhea?
6) Describe the typical presentation of:
- E. Coli
- C. Difficile
7) List routine and high risk treatment recommendations for common bacteria causing acute infectious diarrhea in children:
- Salmonella non-typhi
- Salmonella typhi
- Campylobacter jejuni
- Yersinia enterocolitica
- C. Difficile
- Vibrio cholerae
- Vibrio parahaemolyticus
- E. Coli
8) List the presenting features and treatments for three common protozoa causing infectious diarrhea in children.
9) Define and describe your diagnosis and management approach to dehydration that is:
- Associated with Hypo/Hypernatremia
1) Name 5 causes of bloody diarrhea.
2) Other than vomiting and diarrhea from infectious gastroenteritis, list 6 causes of volume depletion.
3) Name the components of the Gorelick scale.
4) What’s the 4-2-1 rule?
Apr 30 2018
Rank #9: CRACKCast E152 - Cardiovascular Drugs
This episode of CRACKCast covers Rosen’s 9th Ed Chapter 147, Cardiovascular Drugs. With increasingly common use of these medications for heart disease and an ever aging population, it is imperative to understand the prompt recognition and therapy for toxic exposures. Recognition of the more lethal agents and how to disposition these patients in the ED are the cornerstones of this chapter.
Feb 26 2018
Rank #10: CRACKCast E136 - Bone and Joint Infections
- List 6 risk factors for bone and joint infections
- Describe the classification of osteomyelitis (based on pathophysiology)
- List the 3 most common bacteria causing osteomyelitis/septic arthritis for each age group: neonate, child, adult; and the following circumstances:
- Sexually active adolescent
- Infected prosthesis
- Sickle cell disease
- Human bite
- Plantar puncture wound
- Diabetic foot
- Describe a diagnostic approach to osteomyelitis. What is the utility of bloodwork?
- List 4 early findings of osteomyelitis on Xray
- List 5 complications of osteomyelitis
- List 6 differential diagnoses for osteomyelitis
- Describe the empiric management of suspected osteomyelitis
- What is the clinical triad of septic arthritis? Describe typical findings in joint aspiration + radiography.
- List 5 complications of septic arthritis
- What is the triad of disseminated Gonococcal disease?
- List X-ray findings of septic arthritis in a joint with a prosthesis.
- List 10 differential diagnoses for septic arthritis
- Describe the empiric management of suspected septic arthritis
- What is Kocher’s Criteria?
- What is a Biofilm? What is its clinical significance?
Dec 18 2017
Rank #11: CRACKCast E191 – Weapons of Mass Destruction
This episode of CRACKCast covers Chapter 193 in Rosen's Emergency Medicine (9th Ed.) – Weapons of Mass Destruction. Although attacks involving WMD's are relatively uncommon, being thoroughly prepared for these events will prove invaluable for the community affected. Sit tight and listen in to make sure you are ready if the unthinkable should happen.
1) List 6 potential agents that may be used as weapons of mass destruction.
2) List 6 features of weapons of mass destruction threats that make them unique.
3) Describe 6 signs suggesting biologic weapon deployment.
4) What are recommendations for prevention of in-hospital transmission of contagious agents?
5) Describe the 2 typical presentations of Anthrax. What are typical CXR findings? How is each type of anthrax treated?
6) How is the plague transmitted? What are the 2 typical presentations of the plague? How is each treated?
1) Why are children at higher risk of death from Weapons of Mass Destruction (WMD)?
2) What are components of ED preparedness for chemical weapons of mass destruction?
3) Describe a basis ER protocol for handling radiation exposure / casualties (review).
4) Differentiate between chickenpox and smallpox.
5) How are nerve agents treated (3 drugs)?
6) Describe the clinical effects of mustard gas. How is this treated?
Jul 02 2018
Rank #12: CRACKCast E154 - Hallucinogens
This episode of CRACKCast covers Rosen’s 9th Ed Chapter 150, Hallucinogens. This chapter covers exposure to several families of hallucinogenic toxins, their presentations, complications, and treatment.
Feb 15 2018
Rank #13: CRACKCast E206 – Seizures
- Define seizure and provide an explanation of the classification systems for seizure
- Define recruitment as it relates to seizure development and progression
- Differentiate between seizure and syncope
- Differentiate between neurogenic and psychogenic seizures
- List 5 diagnoses that can mimic seizures (see Box 15.2)
- Define status epilepticus and differentiate between convulsive and non-convulsive status epilepticus
- List 10 causes of status epilepticus in adults (see Box 15.1 and 15.3)
- Outline management of status epilepticus.
- List indications for head CT for first seizure.
- List 5 properties of ictal events
- Isoniazid Toxicity
- TCA Toxicity
- What medications are needed to treat seizing patients with the following:
- Name 3 key metabolic abnormalities that can cause seizures
- Name 3 common seizure provokers that can worsen pre-existing seizure disorders
- What percentage of patients with convulsive status epilepticus will develop non-convulsive status epilepticus?
Oct 07 2019
Rank #14: CRACKCast E078 - ACS
This episode covers Chapter 78 of Rosen's Emergency Medicine. Acute Coronary Syndromes... its a gooder.
Acute Coronary Syndromes Part A (Monday)
- Define Stable Angina, UA, AMI
- Describe the pathophysiology of AMI
- What are the components of prehospital management of AMI
- List population RFs for CAD.
- Do they matter in the evaluation of a specific patient?
- List RFs for atypical presentation of ACS. What are the risks of atypical presentations?
- List 8 early complications of AMI and briefly describe the management of each one.
- Describe the progression of ECG changes in STEMI
- List expected ECG changes (ST↑ and reciprocal ST↓) and culprit vessel for the following:
- Anterior wall MI
- Lateral wall MI
- Inferior wall MI
- RV wall MI
- Posterior wall MI
- Describe the ECG characteristics of Left Main Occlusion
- What is Wellens’ sign and what is it’s significance
- List 10 DDx for ST-elevation
- Describe the ECG features of
- Benign early repolarization
- Ventricular-paced rhythm
- LVH / Strain-pattern
- LV aneurysm
What are the STEMI equivalents? Know these patterns!!!
May 16 2017
Rank #15: CRACKCast E187 – The Combative and Difficult Patient
This episode of CRACKCast covers Chapter 189 in Rosen's Emergency Medicine (9th Ed.) – The Combative and Difficult Patient. Next time a severely agitated patient rolls into the department, you won't even break a sweat!
Jun 18 2018
Rank #16: CRACKCast E002 - Mechanical Ventilation
This episode covers Chapter 2 of Rosen's Emergency Medicine.
- What are Indications and contraindications to NIPPV?
- Describe your initial BePAP or CPAP settings?
- What are good initial vent settings?
- How do you troubleshoot the crashing patient on the ventilator?
Jan 15 2016
Rank #17: CRACKCast E177 - Acute Complications of Pregnancy
This episode of CRACKCast covers Rosen’s Chapter 177, Acute Complications of Pregnancy. This chapter covers many acute issues that arise during the unique physiologic state that is pregnancy, from first trimester bleeding to diagnostic challenges and management of other conditions during pregnancy.
May 14 2018
Rank #18: CRACKCast E168 – Pediatric Respiratory Emergencies: Upper Airway Obstruction and Infections
- What is the pathophysiology of inspiratory and expiratory stridor?
- Provide a differential diagnosis for stridor in children (based on location: supraglottic, glottic, subglottic) list at least three in each category.
- What is the typical presentation of a retropharyngeal abscess?
- Describe the management of a RPA. What are the typical pathogens?
- What the typical pathogens in epiglottis? How are these patients managed?
- Differentiate between croup and other conditions mimicking croup.
- Contrast mild, moderate, and severe croup.
- What is the management of croup?
- Which children with croup require admission to hospital?
- Management of upper airway FB: Describe the management of an airway obstruction (progresses from partial obstruction to full obstruction to unconscious) in a 6 month old. In a 6 year old?
- Ddx of stridor (8) (review)
- List 5 Xray findings of epiglottitis
- Which infections are associated with croup?
- How do you handle the CICV scenario?
Apr 09 2018
Rank #19: CRACKCast E071 - Ophthalmology
Apr 17 2017
Rank #20: CRACKCast E170 – Pediatric Respiratory Emergencies: Disease of the Lungs
- Name 8 non-infectious causes that may present as pneumonia
- Describe the workup for a child with suspected pneumonia?
- What are the typical causes of bacterial pneumonia and viral pneumonia in the following age groups:
- < 1 month
- 1 month – 3 months
- 3 months – 5 years
- ≥ 5 years
- What is the empiric treatment of bacterial pneumonia in these age groups for outpatients? For inpatients?
- List 8 complications of pneumonia
- List 6 criteria for admission with pneumonia
- What are three clinical complications of cystic fibrosis?
- What is the pathophysiology of CF?
- How is suspected pneumonia in a patient with CF treated?
- What is the cause of whooping cough?
- What are the stages of whooping cough?
- How is whooping cough managed?
- How is the flu shot used in the pediatric population?
- Describe common pneumonia syndromes:
- Chlamydia trachomatis
- Mycoplasma pneumonia
- What is the most common bacterial infection in CF?
Apr 16 2018