Legal Lessons 6: Missread X-rays
From September 2020, Get Your Game OnAn infant with respiratory complaints may have pneumonia or a viral infection, but an expanded differential to include harder to find diagnoses such as myocarditis may decrease the rate of missed diagnoses and adverse outcomes.
16minMike Weinstock, MD and Matthew DeLaney, MD
PVCs/PACs in UC
From September 2020, Get Your Game OnPAC’s and PVC’s are common findings on ECGs. As always, clinical context is everything. Asymptomatic patients often can follow up with their primary care physician for further work up. Those with symptoms may benefit from expedited follow up with cardiology, or transfer to the emergency department …
21min 44Matthieu DeClerck, MD and Andrew Grock, MD
Blinking Bug Bite
From September 2020, Get Your Game OnMike and Matt discuss a patient presenting with Quincke’s Pulse which is a finding associated with aortic insufficiency resulting in focal arterial dilatation. Here, the arterial dilatation in the area of the bite led to an inability of arterioles to maintain sufficient pressure during diastole …
9min 24Mike Weinstock, MD and Matthieu DeClerck, MD
Legal Lessons: Hip pain with 7 Bounceback Visits
From July 2020, UFBs: Unidentified Foreign BodiesThere are no clinical findings which definitively diagnose or ‘rule out’ a DVT. When this diagnosis is suspected, a doppler study should be done. If missed, a pulmonary embolism may occur. •
20min 2Mike Weinstock, MD and Matthew DeLaney, MD
Strep Pharyngitis Associated Myocarditis (SPAM)
From July 2020, UFBs: Unidentified Foreign BodiesSPAM (Strep Pharyngitis Assoc Myocarditis) was first identified in 1947. It is a rare, non-rheumatic complication of GAS pharyngitis which is important to identify as treatment with antibiotics often results in a full recovery. •
13min 25Mike Weinstock, MD and Josh Russell, MD
What Would I Do Next? | Cerebral Venous Thrombosis
From June 2020, HangryCVT is a rare and dangerous cause of acute headache in young patients. It can beconsidered a DVT of the brain. Patients at risk are those at risk for venous thromboembolism elsewhere. •
16min 9Mike Weinstock, MD and Josh Russell, MD
AAA’s in Urgent Care
From June 2020, HangryMiz and Mike discuss the presentation of abdominal aortic aneurysm (AAA), the diagnosis including ultrasound and CT scan and the possible outcomes in the context of a case of a 92 year old man sent from the urgent care to the emergency department. •
12min 53Mike Weinstock, MD and Mizuho Morrison, DO
Pericarditis & Myocarditis - Part II
From April 2020, Hang Over PalpitationsPericarditis and myocarditis are important disease processes to have on your differential diagnosis for chest pain, shortness of breath, and palpitations. The diagnosis can be difficult to make without picking up on clinical hints in the history, physical exam, and a pathognomonic EKG. Treatment …
13min 16Lauren Sigman MD and Matthieu DeClerck, MD
Pericarditis & Myocarditis - Part I
From April 2020, Hang Over PalpitationsPericarditis and myocarditis are important disease processes to have on your differential diagnosis for chest pain, shortness of breath, and palpitations. The diagnosis can be difficult to make without picking up on clinical hints in the history, physical exam, and a pathognomonic EKG. Treatment …
20min 16Lauren Sigman MD and Matthieu DeClerck, MD
Introduction: Holiday Heart
From April 2020, Hang Over PalpitationsHoliday heart syndrome is transient episodes of atrial fibrillation induced by alcohol consumption, in particular binge drinking. It is typically benign, transient, and resolves within 24-48 hours of cessation of alcohol ingestion. The clinical history of recent heavy alcohol consumption in the …
15min 24Mike Weinstock, MD and Matthieu DeClerck, MD
A Case of a Broken Heart
From February 2020, Clear as Mud...IDSA Guideline Pneumonia updatesStress cardiomyopathy is generally a transient systolic dysfunction of the left ventricle that is often caused by an emotional or physical trigger. Conservative treatment and resolution of the physical or emotional stress usually result in rapid resolution of symptoms, although some patients …
12min 50Matthieu DeClerck, MD and Matthew DeLaney, MD
Legal Lessons - Chest Pain
From January 2020, Mainlining MadnessThe 5 symptoms which have been shown to be concerning historical symptoms are exertional pain, diaphoresis, radiation of pain, vomiting and pain similar to previous MI.
14min 34Mike Weinstock, MD and Matthew DeLaney, MD
SVT and the REVERT Trial
From October 2019, SVT?! REVERT Me!We all remember years ago when we took ACLS for the first time, once we got to the section on SVT, they would always say that we should “try vagal maneuvers” before moving to chemical conversion. Today we are going to review diagnosing SVT and re-examine all of the modalities available to those who …
21min 56Andy Little, DO, Drew Kalnow, DO, and Mizuho Morrison, DO
New Onset Atrial Fibrillation
From September 2019, Off The CuffWhen evaluating a patient with a-fib it is important to consider both rhythm control and also the associated risk of subsequent thrombosis. Even in patients who have brief episodes of a-fib there may be a significant risk of developing a thrombotic complication.
24min 35Matthew DeLaney, MD, Mizuho Morrison, DO, and Ryan Pedigo, MD
Chagas Disease
From August 2019, Disabilities MatterChagas disease is on the rise in the United States and becoming more widespread. Why? How do these patients present, and how do we make the diagnosis and then treat them appropriately? How can we prevent further transmission? In this segment, Drs. Mizuho Morrison and Neda Frayha review the ins and …
17min 24Neda Frayha, MD and Mizuho Morrison, DO
Chest X-Ray Basics | Part One
From April 2019, April Showers, Syncope & SprainsWhen evaluating a chest x-ray providers should ensure that the study has adequate penetration, projection and inspiration. In addition it is important to ensure that the patient is not rotated.
16min 45Mike Weinstock, MD and Matthew DeLaney, MD
What Would I Do Next: Asymptomatic Hypertension
From April 2019, April Showers, Syncope & SprainsHypertension (HTN) is a common condition throughout the world, thought to affect a third of Americans. An urgent care patient with an elevated blood pressure (BP) presents a diagnostic and therapeutic challenge, as the spectrum of disease can span from the asymptomatic, chronic patient who needs …
26min 29Rick Pescatore, DO and Mike Weinstock, MD
Syncope
From April 2019, April Showers, Syncope & SprainsThere are many things that can cause syncope. The workup and management for syncope depends on what you suspect the underlying cause to be. Mizuho and Matt Delaney interview Dr.Amal Mattu on the most recent ACC/AHA/HRS guidelines for the evaluation and management of syncope.
26min 21Amal Mattu, MD, Matthew DeLaney, MD, and Mizuho Morrison, DO
Chest Pain
From March 2019, Bun (Not) In The OvenPatients who present to the urgent care with chest pain can have their initial evaluation performed with an ECG, CXR and troponin testing then be risk stratified to go to the ER or be sent home for expedited outpatient evaluation
27min 4Cameron Berg, MD, Matthieu DeClerck, MD, and Mike Weinstock, MD
Medical Legal Risks Of Low Risk Chest Pain
From October 2018, You'll Shoot Your Eye Out!Amal Mattu discusses two large branches of pitfalls in patients being evaluated for ACS: EKG pitfalls and HISTORY red flags. We discuss pitfalls and red flags relating to medical legal risks when dealing with chest pain.
23min 49Matthew DeLaney, MD, Amal Mattu, MD, and Mizuho Morrison, DO
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