WDIDN: Fishbone in the ThroatFrom July 2021, The Parched Patient
The sensation of a foreign body in the throat can be disconcerting to the patient. Oftentimes this sensation is in response to local mucosal trauma during swallowing. But the diagnosis of a retained body hinges on the ability to visualize, either directly or with radiograph, the foriegn body. Using …12min 49Jessica Osterman, MD, Matthieu DeClerck, MD, and Mizuho Morrison, DO
Seasonal AllergiesFrom May 2021, Apposition So You Can Disposition
Andy Barnett does an in-depth review of how to treat seasonal allergies including how to add /adjust meds for patients who are experiencing severe allergic symptoms despite their current medication regimen.36min 31Matthieu DeClerck, MD, Mizuho Morrison, DO, and Andy Barnett, MD
WDIDN SinusitisFrom March 2021, Pain in the Neck
Lots of folks will get sinusitis, most of these patients will have a virus. It can be hard to figure out who actually has bacterial sinusitis.23min 20Matthew DeLaney, MD and Doug Wallace, MD
Glue Ear (otitis media with effusion/serous otitis media)From May 2020, I Got The Gout!
Rick and Mizuho discuss non-infectious otitis media with effusion, an abundantly common but underdiagnosed entity that presents to offices and urgent cares with startling frequency. Pathogenesis, identification, and management are covered including a review of the data surrounding systemic …16min 49Mizuho Morrison, DO and Rick Pescatore, DO
What Would I Do Next? | Strep vs. MonoFrom March 2020, Fight Bites & Cup O' Noodles...Pain, No Gain!
Andy and Matt run through a case of a patient presenting to UC with a sore throat. Clinical presentation, clinical decision tools, and point of care testing are key to making a diagnosis between strep and mono. The decision to treat with antibiotics is based on making the right diagnosis. Patients …16min 16Andy Barnett, MD and Matthieu DeClerck, MD
Malignant Otitis ExternaFrom February 2020, Clear as Mud...IDSA Guideline Pneumonia updates
Patients over the age of sixty with diabetes, chronic renal disease, or immunocompromised are at the highest risk for malignant otitis externa - misdiagnosis is associated with a high morbidity and potential mortality. Organisms may include pseudomonas as well as methicillin resistant staph aureus …17min 19Ari Leib, MD and Mike Weinstock, MD
An Unusual Case of Sore ThroatFrom December 2019, Medication Mishaps
A sore throat may be caused by group A beta hemolytic strep as well as a virus, but the differential diagnosis in select patients should include gonococcal pharyngitis which is treated differently than routine group A beta hemolytic strep.13min 11Josh Russell, MD and Mike Weinstock, MD
Post-Tonsillectomy ConsiderationsFrom November 2019, Who's The Black Sheep?
Miz and Delaney discuss the management of post-tonsillectomy bleeding. Everything from why this anatomical region is challenging; practical tips on how to stop the bleeding and then what to do about it.17min 13Mizuho Morrison, DO and Matthew DeLaney, MD
What would I do next? | A patient with neck pain and feverFrom November 2019, Who's The Black Sheep?
The differential diagnosis of neck pain is broad, but the presence of unexplained fever or a history of intravenous drug use increases the index of suspicion for a cervical epidural abscess.19min 14Matthew DeLaney, MD and Mike Weinstock, MD
Excellence In Physical Exam Series | Strep ThroatFrom September 2019, Off The Cuff
Strep throat has many physical exam findings, some of which are nonspecific such as erythema and others which are very specific such as palatine petechiae.11min 21Matthieu DeClerck, MD and Mike Weinstock, MD
How to Identify the Sick(er) AsthmaticFrom September 2019, Off The Cuff
Asthma is a common disease process and is also a common presentation to the Urgent Care setting. Most asthma exacerbations are easily controlled with inhaled Albuterol. But when a patient is having a severe asthma exacerbation the clock is ticking! Initiating therapy and immediate transfer to the …13min 40Matthieu DeClerck, MD and Haney Mallemat, MD
IntroductionFrom July 2019, The Half Somersault
There is an easier approach to management of BPPV which patients can learn and use at home called the half somersault technique.16min 51Mike Weinstock, MD and Matthieu DeClerck, MD
Lemierre’s SyndromeFrom June 2019, ID Killers
If there is bacterial penetration from the throat to the internal jugular vein, septic thrombophlebitis can ensue, which is treated with anticoagulation in addition to antibiotics.16min 48Mizuho Morrison, DO and Mike Weinstock, MD
PharyngitisFrom June 2019, ID Killers
Rick and Matt tackle the surprisingly complex topic of pharyngitis and take a deep dive on the microbiology and considerations of antibiotic treatment.18min 17Matthew DeLaney, MD and Rick Pescatore, DO
Nasal FracturesFrom May 2019, Difficult patient vs. personality disorder?
Nasal fractures are common facial injuries. Mizuho and Matt sit down with Oral Maxillofacial Surgeon Dr.David Tucker on diagnosis and management of nasal fractures. •13min 24David Tucker Dds, OMFS, Matthieu DeClerck, MD, and Mizuho Morrison, DO
Deep Throat Badness - Part OneFrom January 2019, Can't We All Just Get Along?
Miz and Matt Delaney discuss overall approach to patients young and old with potential deep throat and neck abscesses. Everything from the common peritonsillar abscess to life threatening retropharyngeal abscess more commonly seen in young children.21min 16Mizuho Morrison, DO and Matthew DeLaney, MD
Deep Throat Badness - Part TwoFrom January 2019, Can't We All Just Get Along?
Miz and Matt Delaney discuss Ludwigs angina diagnosis, management and treatment. They go on to discuss parapharyngeal space abscesses (aka: pharyngomaxillary or lateral pharyngeal space abscess) which can arise via contiguous spread of infection from a PTA or RPA.9min 52Mizuho Morrison, DO and Matthew DeLaney, MD
Perforated Tympanic MembraneFrom November 2018, Breaking Bad - Insulin Pumps and Mandibles
A traumatic tympanic membrane rupture is best diagnosed by physical examination of the ear and visualization of a perforation which may be accompanied by blood in the auditory canal. Symptoms may include pain, tinnitus, vertigo or bleeding. Management is by observation and close follow up.12min 18Mike Weinstock, MD and Matthieu DeClerck, MD
Mandible FracturesFrom November 2018, Breaking Bad - Insulin Pumps and Mandibles
A mandible fracture often occurs from a blunt force injury. Adult fractures may result in significant displacement. It is important to palpate the entire mandible in a systematic fashion as well as to evaluate the mouth and to explore the wound looking for foreign bodies12min 3Matthieu DeClerck, MD and Mizuho Morrison, DO