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August 16, 2019
Have a question you'd like us to answer? Submit your question here: https://www.askmedgeeks.com - You'll need to do a good neurological exam and make sure there aren't any deficits. Are there any focal neuro findings? Who's heard these things before? Who's asked themselves these things before?  There are a ton of indications to do a complete neurological exam on a patient. Perhaps they are altered, have a headache, or have a head/spine injury? Let's be honest here, sometimes the neuro exam can be a little tedious and daunting for both students and clinicians alike. But, it doesn't need to be that way. Today on the Medgeeks podcast, we'll be talking about the neuro exam. Have a question you want answered on the podcast? Submit your question here: https://www.askmedgeeks.com/question - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Check out our course material here: https://medgeeks.co - 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.
August 10, 2019
Have a question you'd like us to answer? Submit your question here: https://www.askmedgeeks.com - Your next patient is a 25 year old man who called in to make a same day appointment.  He has no past medical history, but you know him pretty well. He's always been a bit of a hypochondriac, so you figure it's probably nothing major. When you walk in the room, the patient smiles, and you shake hands. That's when you notice... Today, we'll be talking Bells Palsy.  What is it, how do we diagnose, and how do we treat? - Have a question you want answered on the podcast? Submit your question here: https://www.askmedgeeks.com/question - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Check out our course material here: https://medgeeks.co - 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.
August 4, 2019
Have a question you'd like us to answer? Submit your question here: https://www.askmedgeeks.com - Your next patient is a 21 year old female who was brought in to urgent care by her husband with the chief complaint of fatigue and vomiting. Before you go in to see the patient, you notice she has no past medical history and her vital signs are normal, aside from a heart rate of 122 BPM. The patient thought she was coming down with something, because she was feeling very tired and lost her appetite. She developed vomiting this am. They blame the sushi they ate. During the physical, you notice she looks very ill. She's laying on her side and holding her belly uncomfortably. Her skin looks pale and appears to be dehydrated. So, you ask for a glucose, and come to find, it's extremely high and reads ">500". Today, we'll be talking diabetic ketoacidosis. We will also be answering your questions at the end of our show in the Ask Medgeeks segment, which includes LFTs and clean catch urine samples. - Have a question you want answered on the podcast? Submit your question here: https://www.askmedgeeks.com/question - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Check out our course material here: https://medgeeks.co - 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.
July 27, 2019
Register to our upcoming clinical case webinar: https://www.medgeek.co/stranger-cases-webinar - Your next patient is a 7 year old boy, brought in by his parents with a chief complaint that simply says, "bite". You're walking down the hall, to the patient, all the while wondering what kind of bite we're talking about. As you near the room, you hear the boy crying hysterically. You enter the room and see the mother trying to console the patient, holding a folded up t-shirt to the right side of his face, and there's blood all over the patient's clothes. The boys father is angrily pacing around the room on his cell phone.  The mother states they were playing at the park, when a very large dog began growling, and ultimately bit the patient in the face. The dog was wearing a collar, but they didn't see the owner.  When you examine the face, you see a 3 cm hooked shaped laceration over his cheek and gaping wide open, but doesn't extend all the way to the inside of his mouth.  As the clinician, how will you bring resolution to the family? How would you manage this patient? Todays podcast will be all about animal bites!  - Have a question you want answered on the podcast? Submit your question here: https://www.askmedgeeks.com/question -  Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Check out our course material here: https://medgeeks.co - 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.  
July 20, 2019
Have a question you want answered on the podcast? Submit your question here: https://www.askmedgeeks.com/question . A 22 year old female comes into your clinic and she's complaining of lower abdominal pain which started yesterday.  She has no past medical history.  The patient denies vomiting or fever. She really doesn't have any other complaints aside from the pain, which she states is sharp, but dull at times as well. She then reveals her last menstrual period was 6 week prior. What's one of the first things that should pop into your head when evaluating this patient? Well, that's exactly what we'll discuss on todays episode: Ectopic Pregnancy.  . . Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Check out our course material here: https://medgeeks.co - 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.
July 13, 2019
Today, we'll be discussing the patient presenting with atraumatic joint pain and the many differentials that come along with that. We'll also be answering all the questions everyone submitted at the end of the podcast. Have a question regarding clinical practice, school, exams, or anything medical? Submit your question (free) and we'll answer on the next episode! Submit your question here: https://www.askmedgeeks.com/question . . . Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Check out our course material here: https://medgeeks.co - 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.
July 5, 2019
Submit your questions here: https://www.askmedgeeks.com/ Today, I'd like to introduce Eric Gordon PA-C. He's the newest member of the Medgeeks team and is a physician assistant practicing emergency medicine in Fort Worth, Texas. He graduated from the University of North Texas Health Science Center in 2016. Eric developed a passion for teaching while working as a zipline and ecotour guide in Austin, Texas. He has also taught standardized test prep classes to high school students and currently enjoys training PA and NP emergency medicine residents. On this episode, he'll be breaking down syncope from presentation, the differentials, things to look out for, the workup, and management. We'll finish this all off with a nice case study to see how everything ties together! We want to be more interactive with our community and so we've decided to start doing a Q&A at the end of each episode. If you have a clinical or board review question, use the link below to submit and we'll answer on our next podcast: https://www.askmedgeeks.com/question . . Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Check out our course material here: https://medgeeks.co - 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.
May 15, 2019
Get our free clinical lab guide: https://www.medgeeks.co/labguide - Last week we discussed some scoring systems regarding neuro, cardiac, and respiratory. This week, I want to go over GI, renal, endocrinology, infectious disease, and hematology. Let's get started! - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Check out our course material here: https://medgeeks.co - 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.
April 27, 2019
Get our free clinical lab guide: https://www.medgeeks.co/labguide - Over the next couple weeks, I want to take a break from the normal disease based podcasts. Instead, I want to shift our focus and discuss some high yield useful scoring, equations, and algorithms, such as the NEXUS C-Spine rule, PERC rule, calcium correction for albumin, FENA, free water deficit for hyponatremia, etc. There are a ton to know. But, I want to touch on the ones I use day in and day out.  You're probably thinking... Well, Zach, I can just hop online and use the free calculator.  And, I agree. Use those for the math side of things. However, you need to know why and when to use them to help improve your patient care. I want to break this all down by organ system. This week we'll touch on neurology, respiratory, and cardiac.   So, let's begin! - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Check out our course material here: https://medgeeks.co - 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.
April 22, 2019
Get our free clinical lab guide: https://www.medgeeks.co/labguide - So, you scroll to the next patient on your list and see the chief complaint of "eye problem". This can be anything. From a simple hordeolum to an emergency situation like a retrobulbar hematoma. So, let's go over some common eye problems you might see in the emergency department, urgent care, or primary care office. Enjoy! - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Check out our course material here: https://medgeeks.co - 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.
April 12, 2019
Get our free clinical lab guide: https://www.medgeeks.co/labguide -  Today, we're going to talk about toxic shock syndrome.  You're probably thinking this is the disease associated with tampons and menstrual cycles. Well, let me tell you it's not just menstrual cycle related. In fact, half of the reported case are not menstrual related. Regardless, when you hear toxic shock syndrome, get concerned and get worried. Hopefully, you won't ever have to make this diagnosis, as it's quite lethal. I've seen in one time so far in my career and the case didn't end well. So, let's get started! - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Check out our course material here: https://medgeeks.co - 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.
April 7, 2019
Get our free clinical lab guide: https://www.medgeeks.co/labguide - You have a 54 year old male patient with a past medical history of schizophrenia, ETOH abuse, drug abuse (crack cocaine), hypertension, hyperlipidemia, and diabetes. He was brought in by police for aggressive behavior in public. The patient was roaming the street, yelling and banging on restaurant windows.  Upon police arrival, the patient was awake and alert. However, he wasn't calm or cooperative; ultimately he required restraints by EMS. You're unable to get his vital signs due to his agitation. So, what would you do?  Today, I want to discuss the agitated patient and how we should approach this scenario. - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Check out our course material here: https://learn.medgeeks.co - 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.
March 28, 2019
Get our free clinical lab guide: https://www.medgeeks.co/labguide - 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.  - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Check out our course material here: https://learn.medgeeks.co - 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.
March 22, 2019
Get our free clinical lab guide: https://www.medgeeks.co/labguide - 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! - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Check out our course material here: https://learn.medgeeks.co - 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.
March 18, 2019
Get our free clinical lab guide: https://www.medgeeks.co/labguide - 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. - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Check out our course material here: https://learn.medgeeks.co - 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.    
March 7, 2019
Get our free clinical lab guide: https://www.medgeeks.co/labguide - 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! - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Check out our course material here: https://learn.medgeeks.co - 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.
February 28, 2019
Get our free clinical lab guide: https://www.medgeeks.co/labguide - 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. - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Check out our course material here: https://learn.medgeeks.co - 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.
February 21, 2019
Get our free clinical lab guide: https://www.medgeeks.co/labguide - 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. - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Check out our course material here: https://learn.medgeeks.co - 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.
February 15, 2019
Get our free clinical lab guide: https://www.medgeeks.co/labguide - 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! - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Check out our course material here: https://learn.medgeeks.co - 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.
February 8, 2019
Get our free clinical lab guide: https://www.medgeeks.co/labguide - 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. - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Check out our course material here: https://learn.medgeeks.co - 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.
January 31, 2019
Get our free clinical lab guide: https://www.medgeek.co/clinical-lab-guide25 - 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. - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Check out our course material here: https://learn.medgeeks.co - 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.
January 24, 2019
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 - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Check out our course material here: https://learn.medgeeks.co - 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.
January 17, 2019
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 - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Check out our course material here: https://learn.medgeeks.co - 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.
January 12, 2019
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. - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Check out our course material here: https://learn.medgeeks.co - 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.
January 4, 2019
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) - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Check out our course material here: https://learn.medgeeks.co - 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.
December 28, 2018
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. - Subscribe to our YouTube here: http://www.youtube.com/subscription_center?add_user=medgeeks - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Learn better medicinee: https://learn.medgeeks.co - Have questions? Email team@medgeeks.co - 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.
December 20, 2018
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! - Subscribe to our YouTube here: http://www.youtube.com/subscription_center?add_user=medgeeks - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Learn better medicinee: https://learn.medgeeks.co - Have questions? Email team@medgeeks.co - 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.  
December 13, 2018
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.  - Subscribe to our YouTube here: http://www.youtube.com/subscription_center?add_user=medgeeks - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Learn better medicinee: https://learn.medgeeks.co - Have questions? Email team@medgeeks.co - 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.
December 7, 2018
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!  - Subscribe to our YouTube here: http://www.youtube.com/subscription_center?add_user=medgeeks - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Learn better medicinee: https://learn.medgeeks.co - Have questions? Email team@medgeeks.co - 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.
November 29, 2018
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 - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Learn better medicinee: https://learn.medgeeks.co - Have questions? Email team@medgeeks.co - 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.  
November 23, 2018
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! - Subscribe to our YouTube here: http://www.youtube.com/subscription_center?add_user=medgeeks - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Learn better medicinee: https://learn.medgeeks.co - Have questions? Email team@medgeeks.co - 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.
November 15, 2018
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. - Subscribe to our YouTube here: http://www.youtube.com/subscription_center?add_user=medgeeks - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Learn better medicinee: https://learn.medgeeks.co - Have questions? Email team@medgeeks.co - 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.  
November 8, 2018
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!  - Subscribe to our YouTube here: http://www.youtube.com/subscription_center?add_user=medgeeks - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Learn better medicinee: https://learn.medgeeks.co - Have questions? Email team@medgeeks.co - 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.  
November 1, 2018
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.  - Subscribe to our YouTube here: http://www.youtube.com/subscription_center?add_user=medgeeks - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Learn better medicinee: https://learn.medgeeks.co - Have questions? Email team@medgeeks.co - 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.  
October 25, 2018
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.  - Subscribe to our YouTube here: http://www.youtube.com/subscription_center?add_user=medgeeks - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Learn better medicinee: https://learn.medgeeks.co - Have questions? Email team@medgeeks.co - 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.  
October 18, 2018
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. - Subscribe to our YouTube here: http://www.youtube.com/subscription_center?add_user=medgeeks - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Ace your exams: https://learn.medgeeks.co - Have questions? Email team@medgeeks.co - 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.  
October 11, 2018
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 - Subscribe to our YouTube here: http://www.youtube.com/subscription_center?add_user=medgeeks - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Ace your exams: https://learn.medgeeks.co - Have questions? Email team@medgeeks.co - 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.  
October 4, 2018
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! - Subscribe to our YouTube here: http://www.youtube.com/subscription_center?add_user=medgeeks - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Ace your exams: https://learn.medgeeks.co - Have questions? Email team@medgeeks.co - 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.  
September 27, 2018
As you drive to your rotation, grad school, or to your morning shift in the hospital/outpatient clinic we want to be the podcast you turn to first. My goal with the Medgeeks podcast, is to share my knowledge and experience as an advanced practice provider, in hopes that my pearls improve your day to day practice. With well over 2.2 million downloads, we think it's about time we get some feedback to see how we could improve to better suit your needs. So, we created a short survey in hopes you can help us improve the future of the Medgeeks podcast. All responses are anonymous... Click here to take our short survey We look forward to making each week better than the last! Zach Lavender PA-C
September 20, 2018
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! - Subscribe to our YouTube here: http://www.youtube.com/subscription_center?add_user=medgeeks - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Ace your exams: https://learn.medgeeks.co - Have questions? Email team@medgeeks.co - 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.
September 13, 2018
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! - Subscribe to our YouTube here: http://www.youtube.com/subscription_center?add_user=medgeeks - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Ace your exams: https://learn.medgeeks.co - Have questions? Email team@medgeeks.co - 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.
September 6, 2018
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. - We'd love to hear your feedback: team@medgeeks.co - Subscribe to our YouTube channel here: https://www.youtube.com/medgeeks - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Ace your exams: https://learn.medgeeks.co/ - 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.
September 5, 2018
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 - If you found this helpful like this video and click the link below to subscribe. - Subscribe to our YouTube here: http://www.youtube.com/subscription_center?add_user=medgeeks - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Ace your exams: https://learn.medgeeks.co - Have questions? Email team@medgeeks.co - 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.
August 30, 2018
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. We'd love to hear your feedback: team@medgeeks.co - Subscribe to our YouTube channel here: https://www.youtube.com/medgeeks - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Ace your exams: https://learn.medgeeks.co/ - 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.
August 23, 2018
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! - Subscribe to our YouTube channel here: https://www.youtube.com/medgeeks - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Ace your exams: https://learn.medgeeks.co/ - We'd love to hear your feedback: team@medgeeks.co - 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.
August 17, 2018
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! - Subscribe to our YouTube channel here: https://www.youtube.com/medgeeks - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Ace your exams: https://learn.medgeeks.co/ - We'd love to hear your feedback: team@medgeeks.co - 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.  
August 9, 2018
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 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.  - Subscribe to our YouTube channel here: https://www.youtube.com/medgeeks - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Ace your exams: https://learn.medgeeks.co/ - We'd love to hear your feedback: team@medgeeks.co - 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.  
August 2, 2018
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! - Subscribe to our YouTube channel here: https://www.youtube.com/medgeeks - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Ace your exams: https://learn.medgeeks.co/ - We'd love to hear your feedback: team@medgeeks.co - 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.
July 26, 2018
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. - Subscribe to our YouTube channel here: https://www.youtube.com/medgeeks - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Ace your exams: https://learn.medgeeks.co/ - We'd love to hear your feedback: team@medgeeks.co - 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.
July 19, 2018
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! - Subscribe to our YouTube channel here: https://www.youtube.com/medgeeks - Follow us on Instagram here: https://www.instagram.com/medgeeksinc - Ace your exams: https://learn.medgeeks.co/ - We'd love to hear your feedback: team@medgeeks.co - 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.
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