Certified Emergency Nurse

Today’s conversation has been a long time in the making.  There is no justice I can do in this introduction to Dr. Lewis Goldfrank that would convey the impact he has had not only on me, but on the world. Dr. Goldfrank is the former chairman of the department of emergency medicine at New York read more…

Over the last few days, we’ve been working with Cleavon MD, an emergency medicine physician on the COVID-19 frontlines in New York City, to create this informative and important public service announcement. Please watch and share with all of your family and friends, especially anyone 18 to 40 years old who needs to see this! read more…

Anything said in advance of a pandemic seems alarmist. After a pandemic begins, anything one has said or done is inadequate. –Michael Leavitt, former US Secretary of Health As news surrounding the coronavirus (COVID-19) pandemic continues to evolve at breakneck speed, I have watched firsthand via social media as my physician colleagues work tirelessly to read more…

I have made almost every financial mistake that new physicians should avoid, including going into forbearance and deferment, buying the doctor house and car, not living on a budget, and not prioritizing paying down student loan debt. To be clear, I had significant debt—similar to that of the average graduating medical school student in the read more…

Last year, we wrote about how we have the best customers, and it’s still true. They not only stay calm during a stressful time in their lives, but they continue to send us some of the funniest, heartfelt, and most gracious messages. We can’t keep these notes to ourselves, so here are our favorite customer read more…

When you think of Rosh Review, what do you imagine? Emergency Medicine…Physician Assistant…OB/GYN…Family Medicine…Internal Medicine…Marine Biology… Wait, what? Marine biology? When you look through the qualifications of the Rosh Review team, you may be surprised to find a marine biologist here. We even have an ornithologist and a botanist, too! So what are these ecologists read more…

Talk of burnout among medical professionals is everywhere these days: in medical blogs, in peer-reviewed journal articles, in CME courses, in online courses, and in the news. We can’t avoid hearing about the high rates of burnout, depression, and suicide. I have experienced burnout twice in my career in medicine. The first time was in read more…

Life transitions always take some adjustment…even when they’re exciting changes. Moving, expanding your family, getting a new job—you’ll go through many revisions throughout your lifetime. Sometimes they’re planned and expected, and sometimes they’re not, but each transition requires you to get out of your comfort zone. One of my big life changes was a decision read more…

Like many of you, my background is in health care: I have my Certified Nursing Assistant and EMT certifications as well as a Doctor of Chiropractic degree. Those of us who work in medicine have a passion for science and people, which almost always means leaving home to go to work each day. When you read more…

You’ve done it—you’ve made the big decision to go into medicine. Maybe you’re applying to medical school, maybe PA school, or maybe you’ve graduated and now you’re applying to jobs, but it’s time to get started on your applications. As you’re filling out your information and deciding who to use as your references, you hit read more…

If you’ve emailed Rosh Review for anything, from requesting CME to asking for an extension or seeking clarification about which subscription to purchase, it’s likely that you and I have spoken. I’ve handled the majority of Rosh Review’s customer support for the past three years. We operate with the mindset of equanimity, which means staying read more…

I was inspired and energized at last night’s launch of TIME’S UP Healthcare at the New York Academy of Medicine. I was there as an emergency physician who witnessed gender discrimination and sexual harassment in the workplace, as a father who wants my daughter and son to grow up in a world that treats them read more…

Epiglottitis Patient will be complaining of rapid onset of fever and dysphagia PE will show the patient leaning forward, drooling, inspiratory stridor Imaging will show “thumbprint” sign Most commonly caused by H. influenzae, Streptococcus Treatment is IV antibiotics and airway management Sample question: A 5-year-old boy presents to the emergency department because of difficulty breathing that began a few hours prior to consult. read more…

Ottawa Foot and Ankle Rules X-rays required if Patient cannot bear weight for 4 steps Distal 6 cm tibia/fibula tenderness Medial/lateral malleolus tenderness 5th metatarsal tenderness Navicular tenderness Sample question: A 16-year-old boy presents complaining of right ankle pain after injuring himself while playing basketball. He states that he “twisted his ankle” when he landed on read more…

Sample question: A 17-year-old boy presents to the clinic with right-hand pain after punching a wall. Physical examination reveals swelling over the dorsum of the right hand with bony tenderness noted with palpation of the fifth metacarpal. What is the most likely diagnosis?

Sample question: You are called to the nursery to examine a newborn boy. He was born at 36 weeks via C section to a 32-year-old G3, P3 mother. APGAR scores were 7 and 9. After six hours, the neonate developed respiratory distress. On examination, respiratory rate is 70, with nasal flaring, expiratory grunting, intercostal retractions, decreased breath sounds, and diminished read more…

Transient Tachypnea of the Newborn Patient will be a child shortly after birth Sudden onset of difficulty breathing PE will show tachypnea, nasal flaring, retractions, and hypoxia CXR will show parenchymal infiltrates and fluid in the pulmonary fissures Most commonly caused by residual pulmonary fluid Treatment is supportive, self-resolving within 72 hours Comments: Most common cause of neonatal respiratory distress Sample question: A full-term male infant read more…

Septic Arthritis Patient will be complaining of fever, monoarticular pain with decreased ROM Labs will show WBC > 50,000 with > 75% PMNs Diagnosis is made by arthrocentesis Most commonly caused by: Age < 35: N. gonorrhea, S. aureus overall Treatment is IV ABX, surgical washout Sample question: A 23-year-old man with a history of intravenous heroin use presents to the emergency department with a read more…

Sample question: Which muscle is most commonly involved with rotator cuff injuries?

Megaloblastic Anemia Patient will be a vegan or alcoholic Complaining of fatigue, weakness PE will show pallor, glossitis Labs will show MCV > 100 and hypersegmented neutrophils Most commonly caused by vitamin B12 (Cobalamin) or folate deficiency Comments: only vitamin B12 deficiency results in neurological symptoms Sample question: A middle-aged patient in the ED has a hemoglobin of 8.1 g/dL with an MCV of 112 fL. Which of read more…