CONTENTS Pathophysiology Clinical features Epidemiology Signs & symptoms Relationship between thrombus location & clinical features Investigations Laboratory studies Imaging Treatment Neurologic deterioration despite treatment Prognosis Podcast Questions & discussion Pitfalls anatomy The superior sagittal and transverse sinuses are most frequently involved (in 60% of patients). The internal jugular and cortical veins are involved less often. […]
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Hepatorenal syndrome causing acute kidney injury (HRS-AKI)
CONTENTS Rapid Reference 🚀 Background: Hepatorenal physiology Prevention of HRS-AKI Clinical presentation Differential diagnosis Evaluation Evaluation of the patient with suspected HRS-AKI Traditional approach to the diagnosis of HRS-AKI Streamlined approach to diagnosing of HRS-AKI in the ICU Treatment Transplantation evaluation Vasoconstrictors Albumin & volume management Therapeutic paracentesis Support adrenal function? Hemodialysis Podcast Questions & […]
Diabetic Ketoacidosis (DKA)
CONTENTS Rapid Reference 🚀 Getting started Evaluating anion gap & ketoacidosis Definition & severity of DKA Evaluating the cause of DKA Core components of DKA resuscitation Fluid administration Electrolyte management Insulin infusion Long-acting, basal insulin Management of severe or refractory ketoacidosis NAGMA management Monitoring & management of DKA recurrence Special situations DKA in a hemodialysis […]
Lung cancer
CONTENTS Lung cancer screening Epidemiology Types of lung cancer NSCLC (non-small cell lung cancer) Adenocarcinoma Lepidic predominant adenocarcinoma Squamous cell carcinoma Large cell carcinoma Clinical presentation Management of NSCLC Staging Discussion of specific therapies: Radiotherapy Targeted therapy EGFR mutations ALK fusion gene Chemotherapy Integration of therapies to manage specific situations: Stage I-III: Surgery +/- adjuvant […]
Preeclampsia & HELLP
CONTENTS Rapid Reference 🚀 Diagnosis Presentation & diagnosis Diagnostic criteria Neurodiagnostic tests Treatment Bp & volume management Magnesium for seizure prophylaxis Seizure management (eclampsia) HELLP syndrome treatment Fetal monitoring & delivery Other issues Podcast Questions & discussion Pitfalls lab panel Glucose, electrolytes including Ca/Mg/Phos. Complete blood count. Liver function tests & ammonia. INR, PTT, fibrinogen, […]
Acute decompensated heart failure (including cardiogenic shock)
CONTENTS Rapid Reference 🚀 Intro: what this chapter is about Hemodynamic evaluation & risk stratification Causes of heart failure decompensation Investigations Pulmonary artery catheter Radiologic findings in heart failure Findings may include: Usual CT scan findings in heart failure SCAPE (sympathetic crashing acute pulmonary edema) Asymmetric pulmonary edema Radiological differential diagnosis Treatment Fix the lungs […]
Stress Inoculation Training by Mike Lauria
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Fungal infections of CNS
CONTENTS Cryptococcal meningitis Dimorphic fungi (endemic mycoses) Histoplasmosis Coccidioidomycosis Blastomycosis Molds Aspergillosis Rhinocerebral mucormycosis Candidiasis Podcast Questions & discussion Pitfalls basics Cryptococcus neoformans is a widespread opportunistic fungus found in soil and bird droppings. Cryptococcus gattii causes infection in immunocompetent patients, but it is restricted to specific geographic locales (British Columbia and the Pacific Northwest; […]
Lymphoproliferative diseases
CONTENTS Pulmonary lymphoid neoplasms MALT lymphoma PP-DLBCL (Primary pulmonary diffuse large B-cell lymphoma) Lymphomatoid granulomatosis Pulmonary involvement from systemic lymphoma PTLD (posttransplant lymphoproliferative disorder) IgG4-related lung disease Pleural involvement ➡️ Benign hyperplastic disorders Follicular bronchiolitis (aka BALT hyperplasia) ➡️ GLILD (Granulomatous and lymphocytic interstitial pneumonia) ➡️ Questions & discussion abbreviations used in the pulmonary section: […]
Post-MI complications
CONTENTS Approach to the deteriorating post-MI patient Re-infarction Post-MI pericarditis Bleeding & clotting: Retroperitoneal hematoma Left ventricular thrombus Mechanical complications Mitral valve chordae tendinae rupture Ventricular septal defect (VSD) Ventricular free wall rupture Tachyarrhythmia Atrial fibrillation or atrial flutter Ventricular arrhythmias PVCs Nonsustained VT Sustained monomorphic VT Polymorphic VT AIVR (accelerated idioventricular rhythm) Sinus tachycardia […]
Chronic obstructive pulmonary disease (COPD)
CONTENTS Definitions Epidemiology & risk factors Symptoms Clinical examination Laboratory evaluation PFTs in COPD Radiology: Hyperinflation on radiography Centrilobular emphysema Paraseptal emphysema Panlobular (panacinar) emphysema Chronic bronchitis Bronchiectasis-COPD overlap syndrome (BCOS) ➡️ Diagnosis of COPD Differential diagnosis Differentiation of asthma vs. COPD Disorders causing emphysema (without tobacco exposure) Management Integrated approach to COPD therapies (Inhalation […]
Pleural effusion
CONTENTS approach to pleural effusion of unclear etiology Initial trifecta: History CXR, POCUS, & review of prior radiology Blood tests More advanced testing: CT scan Thoracentesis differential diagnosis All causes of pleural effusion Transudates Exudates pleural radiology POCUS Chest radiograph Subpulmonic effusion Pseudotumor Specific radiologic findings: Chronic pleural effusion Rapidly growing effusion Pleural plus pericardial […]
EMCrit 146 – Who Needs an Acute PCI with Steve Smith (Part I)
Finally in one place, all of the STEMI equivalents with Steve Smith
Post-cardiac arrest management
CONTENTS Rapid Reference 🚀 Cause & investigation Subsequent management: Targeted temperature management (TTM) Shivering management Cardiovascular interventions Pulmonary optimization ID: Aspiration pneumonia & antibiotics Endocrine: steroid Neurologic issues Podcast Questions & discussion Pitfalls investigations ✅ labs Fingerstick glucose. Basic labs (electrolytes including Ca/Mg/Phos, CBC, INR, PTT). Lactate. Troponin. Blood cultures if concern for sepsis. Pregnancy […]
GI Bleeding
CONTENTS Rapid Reference: Overview & Checklist 🚀 Investigations Diagnosis & bedside evaluation Risk stratification Resuscitation basics Causes Specific bleeding location/types Approach to upper GI bleed Variceal bleed Hematochezia and (presumed) lower GI bleed Podcast Questions & discussion Pitfalls history & physical History: NSAID use? Abdominal pain? Alcoholism? Liver disease? Surgical history: Gastric bypass surgery? AAA […]