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Time stamps
00:00 Intro
02:03 Physiology
03:43 Anatomy
04:17 Approach
05:03 Rate
07:20 Rhythm
08:51 Axis
11:33 Conclusion
Learn of basics of interpreting EKGs. This is part 1 of 2, with quick hits focused on the science behind EKGs and how to interpret the rate, rhythm, and axis.
Time stamps
00:00 Intro
00:33 Review of Part 1
02:50 Intervals
07:01 Hypertrophy
09:49 Ischemia
10:35 Everything else
11:27 Conclusion
Part 2 of EKG Basics, we pick up right where we left off in Part 1. Quick review of rate, rhythm, and axis followed by focused hits on intervals, hypertrophy, and everything else.
Time stamps
00:00 Intro
00:45 Overview
03:45 Example 1
07:16 Example 2
11:11 ABG to VBG conversion
12:37 Conclusion
Kelsey walks us through the basics of how to interpret Arterial Blood Gas results.
Time stamps
0:00 Intro & disclaimer
1:03 Potassium
3:12 Calcium
6:01 Magnesium
8:19 Phosphate
8:52 Sodium
9:33 Summary & Outro
You've discovered hypo----emia in your patient, so now what? How do you actually replace electrolytes? Especially when low levels can kill your patient! We walk through the basics of electrolyte replacement with dosing, routes, rates, and a few puns.
Time stamps
0:00 Intro & disclaimer
1:16 Study details & data
3:23 Findings
4:46 Applications
5:29 IDSA guidelines
6:30 Ab half life
6:59 Adaptive immunity
7:44 Post-COVID syndrome
9:28 Key points & Outro
Ben walks us through the current status of COVID antibody tests (as of 9/16/20).
Should you get one? When are they most accurate? What information do they actually give us?
Time stamps
00:00 Intro
00:55 Disease spectrum
03:13 Clinical presentation
04:14 Labs
05:48 Differential
06:50 Severity scoring
09:25 Treatment
12:22 Extra-hepatic disease 1
3:44 Summary & outro
Alcohol and the liver just don't mix. In this episode, John walks us through how to diagnose, classify, and initiate treatment for alcohol-induced hepatitis.
Time stamps: 0:00 Intro 0:53 Definitions 2:14 PFTs 2:47 GOLD Classification 4:56 Treatment 8:22 Key points & Outro
Which inhalers? When do you add them? Oral medications? And what's all this talk about Gold?
Join us to clear the air on goal-directed medical therapy for COPD.
Time stamps
00:00 Intro
01:37 Basics
02:38 Infections
03:50 Indications
05:13 Clinical applications
08:38 Does it work?
11:59 Future directions
12:51 Key points & Outro
What does procalcitonin tell us? In what clinical situations is it useful? Should we be ordering it?
Ben addresses these questions and more with many references for you to do more
digging into this clinical conundrum.
Time stamps
00:00 Intro & disclaimer
01:52 Consolidation
03:43 Ground Glass Opacities
05:19 Reticular Opacities
06:59 Nodular Opacities
08:52 Tree-in-Bud
09:40 Cystic Lesions
10:50 Honey Combing
12:10 Bronchiectasis
13:31 COVID Lung
16:00 Outro
CT radiology reports can be super intimidating. We break down some of the common terms and correlate them to the image findings to help you become better able to understand what's going on in your patient (and even get the gist of what's going on before the official read is available!).
Time stamps
00:00 Intro & disclaimer
01:12 Clinical definitions
03:04 Lifestyle changes
06:30 Metformin
08:38 2nd line options
11:36 Insulin
11:56 A1c & weight
13:21 Big picture
14:54 Key points & Outro
Having an array of options is generally a good thing in life. But when it comes to medications, a wide array can make the decision process much more difficult and confusing. In this episode we walk through the medications class options for diabetes management including the hierarchy of when to use what class, specific indications, contraindications, and adverse effects.
Time stamps
00:00 Intro & disclaimer
00:57 Definition & risk factors
02:30 Differential
03:48 Diagnosis
04:53 Treatment
06:01 Prevention
07:49 Key points & Outro
Who's at risk for aspiration pneumonia? Is it always a true infection? What do we need to empirically treat for? And how can we prevent it in the first place?
Time stamps
00:00 Intro & Overview
01:20 Who's at risk?
02:26 Physiology
04:03 Pathophysiology
08:12 Signs & symptoms
09:14 Risk factors
10:15 Diagnosis
10:31 Prophylaxis
12:14 Monitoring
13:40 Treatment
13:55 Key points & Outro
Nutritional rehabilitation is critically important for healing to be possible, but if done without caution it could lead to potentially deadly complications with rapid onset. But the best treatment is prevention, so have a high index suspicion for any patient at risk, and you could save them from disastrous consequences.
Time Stamps
00:00 - Intro & disclaimer
00:45 - Crystalloids
02:09 - 0.9% Normal Saline
03:55 - 0.45% Normal Saline
05:05 - 3% Normal Saline
06:26 - Lactated Ringers
07:57 - 5% Dextrose
09:44 - Maintenance
11:13 - How to order IVF
12:59 - Summary table
13:10 Key points & outro
IV fluids are one of (if not the) most common medications given in the hospital. But what's actually in them? What do they do after being infused? Which one is best for your patient? How do you even order them? In this intro to IV crystalloid fluids, we walk through the basics of Normal Saline, Lactated Ringer's, and 5% Dextrose to help you understand these ubiquitous but critical medications.
Time Stamps
00:00 Intro & disclaimer
01:28 Conceptualize
02:13 Classifications
05:05 ADH
07:53 Tx: Hypovolemic
09:29 Tx: Euvolemic 12:20
Tx: Hypervolemic
14:46 Key points & Outro
The awaited follow-up to our electrolyte replacement episode! We finally address the conundrum of hyponatremia, which actually is more of an issue with water than with sodium. Find out how to classify hyponatremia, figure out the underlying cause, and fix the imbalance with many screenshot-able
charts and diagrams along the way.
Click for a FREE download of The Fluid, Electrolyte, and Acid-Base Companion
Time Stamps
00:00 Intro & disclaimer
01:27 Algorithm
01:51 ADH physiology
03:29 Diagnosis
05:19 Causes & treatment
09:25 Example
11:34 Last resort
12:32 Key points & outro
Bonus follow-up to the Hyponatremia episode! In this episode we focus on the Syndrome of Inappropriate ADH with a treatment approach that allows you to calculate exactly what fluid restriction you should recommend for your patient with SIADH to correct their hyponatremia over a duration that you deem appropriate.
Click for a FREE download of The Fluid, Electrolyte, and Acid-Base Companion
Time stamps
00:00 Intro & disclaime
00:56 Estimated Due Date
02:42 H&P
03:23 Initial testing
04:26 Counseling
06:24 Genetic screening
08:14 Immunizations
08:34 Interventions
11:46 Fetal evaluations
14:45 Complicating conditions
15:19 References & Outro
Prenatal care is essential for a healthy pregnancy and a healthy infant. In this episode we go through the essentials of prenatal care visits, important information to provide for your patient, how to assess possible complications, and more.
Time stamps
00:00 Intro & disclaimer
00:50 Physiology
01:27 Definitions
02:20 Spectrum
03:10 Pathophysiology
04:36 Risk factors
05:03 Management
07:28 Key points & references
Hypertension in a pregnant woman can have a variety of implications and consequences. But why does it happen in the first place, and why is it such a big deal? In this video we walk through the disease spectrum of hypertensive disorders of pregnancy including pathophysiology, risk factors, and management strategies ranging from watchful waiting all the way to magnesium prophylaxis and emergency delivery.
Time stamps
00:00 Intro & disclaimer
01:14 Indications
01:59 Contraindications
02:32 Bishop Score
02:56 Cervical Ripening
05:19 Labor induction
06:05 References
When is an induction of labor indicated? What is the process, and what are some tools to help the process? In this video we address these questions and more, including how to use the Bishop score, pros & cons of different methods to ripen the cervix, and pros & cons to different induction strategies.
Time stamps
00:00 Intro & disclaimer
00:45 Terminology
03:08 Visual strip basics
04:00 Variability
04:33 Decelerations
06:42 Categories
07:33 Presenting the strip
08:12 Interventions
08:50 References & outro
In the final video of our OB series, we walk through how to interpret a fetal heart tracing. All those graphs mean something, but how do you differentiate and make sense of the heart rate, variability, accelerations, decelerations, and contractions? And more importantly, what does that information tell you about the status of the mother, health of the fetus, and what interventions are indicated?
Time stamps
00:00 Intro & disclaimer
01:05 Differential Dx
01:25 Unstable
02:41 Urgent meds
03:22 Dx algorithm
04:03 Multifocal atrial tachycardia
05:36 Atrial fibrillation
08:53 Atrial flutter
12:29 References
A nurse calls to inform you that your patient's heart rate is 167. What do you do next? How do you figure out what's going on? In this first of a 2-part series on narrow complex tachycardia, we outline a simple approach to diagnosing these arrhythmias starting with the irregular rhythms.
Time stamps:
00:00 Intro & disclaimer
01:01 Review of part 1
01:36 Approach
01:53 Sinus Tachycardia
03:02 Atrial Tachycardia
04:33 AVnRT
07:26 Accelerated Junctional Tachycardia
09:12 Atrial Flutter
10:27 Summary
Fear EKGs no more! In this second video of our 2-part series on narrow complex tachycardia, we walk through a simple approach to the regular rhythms so that you can quickly diagnose these arrhythmias and start the appropriate treatment for your patient.
Time stamps
00:00 Intro & disclaimer
01:34 Hemoglobin A1c
02:27 Oral meds
03:55 Target glucose
04:57 Insulin type chart
05:17 Basal - bolus
06:00 Sliding scale
07:11 Pt already on insulin
08:33 Pt not on insulin
11:11 EMR order
12:48 Key points & references
A significant proportion of adult patients admitted to the hospital have diabetes.
But there are two big problems with this...
1: Many illnesses requiring hospital admission alter the patient's insulin requirements and blood glucose levels during the acute illness.
2: Most of the non-insulin diabetes medications aren't on hospital formularies. In this two-part series, we walk through what the ins and outs of ordering insulin in the hospital for non-critically ill patients.
Part 1 of our insulin series focuses on how to determine the initial dose and orders on admission.
Time stamps
00:00 Intro & disclaimer
00:58 Adjusting the dose
04:06 Example 1
06:31 Example 2
11:19 Key points & references
In part 2 of our series on inpatient insulin, we talk about how to use the POC glucose values from the day before to adjust your patient's insulin doses. We also walk through two example patients, one with a pre-existing insulin regimen and one without. Finally, we address the conundrum of steroid-induced hyperglycemia.
Time stamps
00:00 Intro
00:43 Anatomy
01:25 "O" Classification
02:38 Clinical Manifestations
05:30 Upper vs. Lower GI Bleeds
08:01 History
09:10 Physical Exam
10:52 Clinical Pearls
In part 1 of this series on gastrointestinal bleeding we discuss terminology, clues to differentiate upper and lower GI bleeds, key historical and physical findings, and how the ways that patients typically describe symptoms correlate with medical classifications.
Time stamps
0:00 Intro
1:16 Prophylaxis options
2:39 Risk scoring: VTE
3:16 Risk scoring: Bleeding
3:59 Chemoprophylaxis
5:48 Low-risk patients
6:50 Summary
7:50 COVID-19
9:20 Outro
Venous thromboembolism is a source of considerable morbidity & mortality in hospitalized medical patients. But, there's a fine line between preventing clots and causing bleeding. In this episode we discuss non-pharmacologic & pharmacologic prophylaxis options, how to weigh the risk of VTE against the risk of bleeding, and which patients to consider for which type of prophylaxis.
Time stamps
00:00 Intro & basics
02:55 Acetaminophen
03:35 NSAIDs
04:50 Aspirin
05:25 Opioids
08:11 Tramadol
09:02 PCA
10:44 Regional anesthesia
11:50 ICU
12:31 Outro
Patients in the hospital can have very severe pain, and it's extremely important to address their pain in a way that is safe and effective. In this episode we walk you through different options and specific examples for various levels of inpatient pain control that can be applied to patients of all types.
Time stamps
00:00 Intro
00:14 Logistics
02:11 Full code
02:38 Terminology
03:49 Reality of CPR
05:14 DNAR-FI
06:25 DNAR-LI
07:45 DNAR-CMO
09:05 Summary table
09:31 Code discussion
11:46 Outro
Discussions about code status are critically important and often times emotionally taxing. But the translation of a patient's wishes into hospital code status can be confusing and is filled with abbreviations. DNR, DNAR, FI, LI, CMO... In this video we break down different code status designations to clarify what interventions are included or excluded, as well as what the goal is for the patient's care. This will help you not only to understand the terms for yourself, but also to better guide your patients to a code status that aligns with their wishes and values.
Time stamps
00:00 Intro
00:20 Causes
01:26 Epidemiology
03:34 Symptoms & pathophysiology
05:00 Classification
06:13 Treatment
08:08 Cardioversion
09:37 RVR
10:41 Other management
11:48 Key points & outro
Atrial fibrillation is extremely common, but its management can be confusing. There are many different factors that go into treating A-fib, and they each depend on patient characteristics, hemodynamics, risk factors, and provider expertise. This episode is an overview of A-fib including causes, pathophysiology, acute treatment, and chronic management.
Time stamps
00:00 Intro
00:41 Chest pain
01:23 Best next step
03:15 Stress test indications
04:22 Stress the heart
05:13 Look for ischemia
06:10 Interpreting results
09:36 Summary
10:18 AMBOSS
Stress tests are super common and are an important tool in both risk stratifying patients with suspected coronary artery disease and helping to guide the next best step in workup or treatment. But there are many components to stress tests, and they tend to mix & match. In this episode, we explain how to determine if your patient needs a stress test, what the options are for stressing the heart, the basics of how to interpret the results, and what to expect on the report.
Time stamps
00:00 Intro
00:41 Hypoxia
01:15 Normal physiology
02:22 Shunt
03:55 Diffusion barrier
05:55 V/Q mismatch
08:11 Hypoventilation
09:30 Low PiO2
10:13 Summary table & AMBOSS
Both acute and chronic hypoxemia are abundant among patients in both the inpatient and outpatient worlds. Figuring out the etiology of the hypoxemia is critical for appropriate correction of the hypoxemia and treatment of the underlying cause. To keep your head on straight and avoid feeling overwhelmed with mile-long differentials, think about hypoxemia in five buckets: shunt, diffusion barrier, V/Q mismatch, hypoventilation, and low PiO2. In this video, we walk through each of those buckets so that you can understand key diagnostic features, treatment principles, and management implications that will help you to take the best care of your patients.
Time stamps
00:00 Intro
00:40 Hypercapnic vs hypoxemic
02:24 Physiology & pathophysiology
03:42 Supplemental O2
05:11 Bag-valve mask
05:40 Nasal canula
06:22 Face mask
06:47 Non-rebreather
07:30 Venturi mask
07:58 High flow nasal canula
08:44 Heated high flow nasal canula
09:56 CPAP
11:24 BiPAP
13:31 Intubation
13:51 Summary & AMBOSS
Respiratory failure is not only common, it's also a terrifying experience for patients. In this episode we break down the two major types of respiratory failure: hypercapnic and hypoxemic. Then, we walk through various types of interventions and when to think about using which one, from bag-valve mask and nasal canula all the way to BiPAP and intubation.
Time stamps
00:00 Intro
00:40 The process
02:52 Chemistry panels compared
03:57 Blood tubes
08:58 Add-on tests
09:59 Unique tubes
10:45 Blood cultures
12:35 Comparative costs
15:12 From lab techs & phlebotomists
16:01 Summary & AMBOSS
Labs are foundational to the practice of medicine and significantly affect our work every day. But our training includes little (if any) information about how the lab functions, who the amazing staff in the lab are, and what factors go into the process in between placing the order and receiving the result. This episode aims to give you a basic understanding of the elements of the laboratory that affect your daily work so that you can be more efficient, effective, and savvy with labs.
Time stamps
00:00 Intro
00:40 General management
02:04 Red flags & underlying causes
02:33 Pathophysiology
03:14 Central nausea
04:16 Vestibular nausea
05:26 GI nausea
07:16 Toxic/metabolic nausea
07:34 Chemotherapy induced nausea
09:05 Summary by drug class & symptom
11:09 Outro & AMBOSS
Nausea can be debilitating and it can be the result of a variety of different etiologies. While you're working up the underlying pathophysiology, it's important to know how to best alleviate your patient's nausea. In this episode, we break nausea down into four main buckets and explain why certain classes of medications will most effectively target a patient's nausea depending on which bucket they fall into.
Time stamps
00:00 Intro
00:54 Red flags
01:20 Iron deficiency
03:32 Oral iron
04:44 IV iron
05:37 B12 deficiency
06:13 B12 repletion
07:30 Folate deficiency
09:37 Chronic kidney disease 1
1:48 Take-aways
12:59 Outro & AMBOSS
Most clinical-level med students could rapidly spout off the textbook lab parameters to differentiate iron vs vitamin B12 vs folate deficiencies... but what about when you have a real patient in front of you? And what if the lab results aren't totally clear? In this episode, we pick up where Step 1 & Step 2 left off, and launch into practicalities of diagnosing and treating these forms of anemia.
Time stamps
00:00 Intro
00:47 EKG leads
02:09 Erratic baselines
04:05 V-tach alarms
07:26 Lead I sign
07:53 P wave morphology
10:08 Outro & AMBOSS
The goal of this episode is to share some practical clinical EKG pearls to make quick interpretation a little easier. I'll cover different types of interference that mimic dangerous rhythms, subtle findings that can clue you in to particular diagnoses, and other helpful tips. Be on the lookout for part 2 with a second round of tips including how to decipher dangerous patterns within heart blocks.
Time stamps
00:00 Intro
00:48 (Almost) impossible p-wave
03:31 Bundle branch block ischemia
05:05 2º AV block (Mobitz I)
06:25 2º AV block (Mobitz II)
07:36 2:1 AV block
09:01 Sources & AMBOSS
10:18 Outro
Part 2 picks up where part 1 left off (so make sure to watch part 1 first)! This episode is all about the QRS and how it can give you major insights into the diagnosis. The width, morphology, and amplitude of the QRS can differentiate common from rare, benign from dangerous, and stable from unstable. With just a baseline understanding of electrophysiology, you'll be picking up EKG clues in no time.
Time stamps
0:00 Intro
0:28 Physiology
1:02 Loop diuretics
1:53 Initial inpatient dose
2:33 Goal I/O
3:08 Reliability of charted I/O
4:11 Daily standing weights
4:44 Summary
5:32 Outro
An acute heart failure exacerbation is one of the most common admitting diagnoses that we see in the hospital. An aggressive IV diuretic regimen is key to getting these patients feeling better and out of the hospital as soon as possible. But how exactly to choose that IV regimen and adjust along the way is very patient-dependent and can be tough to predict from the start. In this episode, we cover how to choose the initial diuretic dose and how to monitor your diuretic success. In Part 2, we'll talk about complicating factors that arise including electrolyte imbalances, pharmacodynamics, and side effects.
Time stamps
00:00 Intro
0:48 Electrolyte replacement
2:04 Threshold effect
2:46 Dosing strategy
3:30 gtt (IV drip)
4:53 Thiazide augmentation
5:55 Metabolic alkalosis
6:58 Dose timing & patient sleep
8:03 Loop myalgias
8:43 Summary
Aggressive IV diuresis can result in significant symptomatic and functional improvements for a patient, but there are a few major roadblocks along the way that you might run into. In this second of our 2-part series on IV diuresis, we talk about complications to watch out for, dosing adjustment strategies to try, and clinical tips to make your patient's hospital stay more efficient and comfortable.
Time stamps
00:00 Intro
0:15 Non-pharmacologic
01:16 Secondary causes
01:48 Fiber
02:03 Osmotic laxatives
03:01 Stimulant laxatives
03:34 Suppositories
04:46 Enemas
05:50 Opioid antagonists
06:35 Example framework
07:19 Clinical pearls
Constipation is a super common and very uncomfortable problem that often times gets overlooked by doctors. But constipate no more - we're here to help. In this video we go through various approaches & strategies to both prevent and treat constipation. We cover non-pharmacologic, oral medications, suppositories, enemas, and more. Because let's face it. Poop is important for health. So let's get moving.