Medgeeks Clinical Review Podcast
406 episodes - English - Latest episode: 16 days ago - ★★★★★ - 939 ratingsOur goal is to change the way students and clinicians learn medicine. We are dedicated to providing the best medical content to help clinicians get through school, the boards, and to excel in clinical practice.
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Episodes
Murmurs
December 06, 2019 00:24 - 17 minutes - 18.3 MBOur goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously Improve your work life balance ...or anything in between, we can definitely help. We've worked with thousands since 2013 and we're confident we can help take your career and life to the next level....
Anemia Part 3- Macrocytic Anemia
November 20, 2019 04:13 - 15 minutes - 16.6 MBWelcome to the medgeeks podcast, this is Eric Gordon and we are going to be finishing up our conversation on anemia today. If you haven't done so already be sure and check out our two previous episodes on anemia. Part One was microcytic anemia and Part Two normocytic. Today we are finishing up with part three and that is macrocytic anemia. We're talking B12, we’re talking folate, we're talking alcohol. We're going to get into the workup to figure out what's causing a macrocytic anemia a...
Anemia Part 2 - Normocytic Anemia
November 09, 2019 07:21 - 12 minutes - 14.4 MBToday we are continuing our discussion on anemia, and we are focusing Normocytic Anemia. If you missed it last week, we talked Anemia Part 1: Microcytic Anemia. If you missed it go check it out. Lets go ahead and get started: Today we are going to discuss: How to approach Normocytic Anemia Best way to work-up Normocytic Anemia The Causes and Pathophysiology Decreased Production Increased destruction or sequestration Blood-loss Fluid over-load The most common cause of No...
Anemia Part 1 - Microcytic Anemia
November 08, 2019 23:30 - 14 minutes - 14.9 MBA 21 yo F presents c/o of increasing fatigue and occasional SOB. Her sx have been gradual in onset over the past few weeks. She denies: chest pain, cough, fever & leg edema. Vital signs are normal. No other complaints or Past Medical History. You obtain some labs that show you what you believe to be the answer. Hgb - 7.8 3 months ago: Hgb - 12.5 Whats the next step? What's the cause? How do you manage this? This week on the Medgeeks podcasts we discuss.. ANEMIA! - Our goal at Medg...
Orbital Cellulitis
October 30, 2019 18:06 - 11 minutes - 12.2 MBYour next patient is an 8yo girl; her mother brought her to your office because she has a red painful left eye. Her mother believes this is “Pink Eye”. There has been no drainage or any known exposure. On exam, you see a significant amount of edema and erythema of the upper and lower eyelids and the surrounding soft tissue. The patient’s eye is effectively swollen shut and she is complaining of pain when you try to open the eye. However, you can see there is conjunctival injection. She ...
Approaching Vertigo!
October 21, 2019 22:56 - 22 minutes - 24.6 MBA 43 year old male with a past medical history of hypertension, diabetes, and hyperlipidemia presents to the emergency department with dizziness that started 14 hours ago. He complains of nausea and vomiting. He denies recent trauma, fever, headache, visual disturbance, or weakness. He says he requires the assistance of his wife to walk because he feels unsteady. His symptoms are relieved when he sits down at rest, but they never fully resolve. When you speak to him, his symptoms look...
Mastoiditis
October 16, 2019 17:19 - 15 minutes - 16.2 MBEar pain! I see it almost every shift in the ED. Most of the time it is pretty routine stuff, otitis media, swimmer's ear, occasionally a foreign body in the case of some adventurous toddlers. Bottom line, not really emergencies, MOST OF THE TIME! But what happens when ear pain presents in a really sick patient, who's at risk for serious life threatening complications if they are not managed appropriately today, right now? Today on the Medgeeks podcast we're talking Mastoiditis! -...
Hypercalcemia
October 07, 2019 19:24 - 12 minutes - 12.3 MBYour patient is furious! He showed up to your office this morning demanding to speak with you regarding his most recent lab results. You had seen him for a routine visit two days ago, and you haven't had a chance to review the results, that came in late last evening... ...but the patient had. While reviewing the labs through his patient portal, the patient noticed something that concerned him very much: he noted his calcium was elevated. Not knowing what that means, he did what any...
Ankle Injuries
September 30, 2019 23:40 - 16 minutes - 16.4 MBDoes every twisted ankle need to be imaged? Does a negative ankle x-ray mean there isn't any need for ortho followup? Does every ankle fracture need to be placed in a splint and made non-weight bearing? Today, we'll be discussing the high yield topics related to ankle injuries...as well as some clinical pearls, so you don't get burned! At the end, we'll be staring a question from one of our listeners, regarding thee DVT. - Our goal at Medgeeks is to help you live the life you wa...
Croup
September 23, 2019 02:13 - 14 minutes - 14.5 MBYour first patient of the morning is an 18 month year old female patient who's brought to the clinic by her mother. The chief complaint is cough and difficulty breathing. The patients mother states she was up all night due to the nearly constant coughing. On exam, the girl appears very fatigued. She has a pervasive non-productive barking cough. You also notice there is tachypnea and stridor. Her O2 saturation is 97% and her lungs are clear. So, what's the plan? Today on the Medge...
[part 2] Pulmonary Embolism
September 17, 2019 04:37 - 20 minutes - 20.7 MBToday is part 2 of our discussion regarding pulmonary embolism! In part 1, we discussed the pathophysiology and presentation for pulmonary embolism. Today's episode will be focused more so on the workup of pulmonary embolism and how we're going to manage these patients. - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to .....
[part 1] Pulmonary Embolism
September 10, 2019 18:13 - 12 minutes - 12.3 MBA 29 year old female presents to the emergency room with chest pain and shortness of breath that started last night. The pain is located on her right anterior chest and she describes it as sharp and stabbing and is worse when she takes a deep breath. The EKG in triage shows she's in sinus rhythm at a rate of 114 without signs of ischemia. She appears anxious and when asked, she states she has a history of panic attacks. She denies cough, URI symptoms, back pain, fever, leg swelling. T...
Kidney stones
September 04, 2019 02:42 - 14 minutes - 15.4 MBIt's 7:30 am and a 55 year old male presents to your emergency department complaining of stabbing pain in his right side, which woke him up from sleep, about 20 minutes ago. As you walk into the room, you see him pacing around, clutching his side and slightly hunched over. He won't sit still and can barely complete a sentence before groaning from all the pain. He has a past medical history of hypertension and diverticulitis. He denies any associated symptoms and states yesterday he fe...
The Neurological Exam Part 2
August 26, 2019 19:58 - 16 minutes - 17.3 MBToday, we'll be finishing up our discussion on the neurological exam. Last week, we talked about the cranial nerves and the motor exam. This week, for part 2, we'll be discussing reflexes and the sensory exam. At the end, I'll go over the flow I use in the emergency department. Afterwards, we'll be answering your questions about nystagmus and right ventricular MIs. - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks ...
The Neurological Exam Part 1
August 16, 2019 20:01 - 15 minutes - 15.7 MBYou'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 does...
A droopy smile!
August 10, 2019 06:21 - 14 minutes - 14.5 MBYour 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? - Our goal at Medgeeks is to help you live the life you want to...
Diabetic Ketoacidosis
August 04, 2019 23:21 - 17 minutes - 18.5 MBYour 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...
Animal bites
July 27, 2019 02:15 - 20 minutes - 19.2 MBYour 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 pa...
Ectopic Pregnancy
July 20, 2019 02:34 - 17 minutes - 16.6 MBA 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...
Atraumatic Joint Pain
July 13, 2019 19:55 - 25 minutes - 24.7 MBToday, 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! - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks diff...
Atraumatic Joint Pain
July 13, 2019 19:55 - 25 minutes - 24.7 MBToday, 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.instag...
Syncope (what would you do): Differential, Workup, and Management
July 05, 2019 20:22 - 23 minutes - 23.1 MBToday, 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...
Medical Scoring Part 2
May 15, 2019 02:03 - 12 minutes - 14.2 MBLast 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! - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we take such a personalized approach. Whether you want to ... Stop taking your work home Have the skillset to work autonomously ...
Medical Scoring Systems Part 1
April 27, 2019 00:12 - 12 minutes - 14.3 MBOver 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 calcul...
Medical Scoring Systems Part 1
April 27, 2019 00:12 - 12 minutes - 14.3 MBGet 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 probabl...
Eye Problems
April 22, 2019 19:25 - 10 minutes - 12.4 MBSo, 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! - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. This looks different to everyone, which is why we ta...
Toxic Shock Syndrome
April 12, 2019 21:35 - 9 minutes - 11.3 MBToday, 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 ...
The Agitated Patient
April 07, 2019 01:04 - 9 minutes - 10.9 MBYou 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 h...
Tumor Lysis Syndrome
March 28, 2019 22:37 - 6 minutes - 7.75 MBSo, 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. - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medic...
Managing Vaginal Bleeding
March 22, 2019 02:10 - 11 minutes - 13.7 MBAs 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'...
Syncope: what is the approach?
March 18, 2019 18:15 - 11 minutes - 13.2 MBLately, 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 w...
Serotonin Syndrome
March 07, 2019 22:09 - 10 minutes - 11.6 MBToday, 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, 1...
Anticholinergic Toxicity
February 28, 2019 21:18 - 10 minutes - 11.9 MBToday, 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...
Tylenol Overdose
February 21, 2019 15:54 - 8 minutes - 9.62 MBWe 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 ...
Acute Opioid Overdose
February 15, 2019 20:11 - 8 minutes - 10 MBOver 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. ...
Acute Pancreatitis
February 08, 2019 02:08 - 14 minutes - 16.9 MBWe 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. ...
Thrombotic Thrombocytopenic Purpura (TTP).
January 31, 2019 06:27 - 8 minutes - 9.66 MBToday, 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 ...
ACE Inhibitors and Angioedema
January 24, 2019 19:19 - 7 minutes - 8.33 MBToday, 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...
Acute Migraine
January 17, 2019 19:43 - 10 minutes - 12.3 MBAs 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 h...
Obstructive Sleep Apnea: A Rapid Fire Review
January 12, 2019 21:36 - 6 minutes - 6.92 MBThis 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 Symp...
Sepsis Updated Guidelines
January 04, 2019 01:32 - 19 minutes - 22.8 MBSepsis 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...
Pulmonary Hypertension
December 28, 2018 02:10 - 11 minutes - 12.9 MBToday, 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. - Our goal at Medgeeks is to help yo...
Rhabdomyolysis
December 20, 2018 07:12 - 7 minutes - 8.92 MBThe 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 ...
COPD exacerbation
December 13, 2018 08:21 - 9 minutes - 10.5 MBToday, 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 vi...
Anticoagulation reversal agents
December 07, 2018 03:47 - 7 minutes - 8.81 MBLast 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 surg...
Anticoagulation
November 29, 2018 06:51 - 13 minutes - 15.5 MBToday, 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 ...
Peritonsillar Abscess
November 23, 2018 22:05 - 7 minutes - 8.58 MBI 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 c...
Influenza: just the facts
November 15, 2018 16:58 - 6 minutes - 7.71 MBIt'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. - Our goal at Medgeeks is to help you live the li...
Hyperparathyroidism
November 08, 2018 19:20 - 9 minutes - 10.4 MBHyperparathyroidism 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! - Our goal at Medgeeks is to help you live the life you want to live as you navigate a career in medicine. ...
Hyponatremia
November 01, 2018 16:20 - 9 minutes - 11.3 MBToday, 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 hyponatr...