Podcast Ep 13: Shoulder Dislocations, GERD, Burns, Ethanol Abuse, & More

January 18, 2017

You must do the things you think you cannot do.
-Eleanor Roosevelt

Welcome back to lucky Episode 13! We will start with a cardiology review based on teaching points from prior episodes. Then, we will take you through some new topics from orthopedics to burns.

  • Hypertension is the most common finding in acute aortic dissection.
  • Fusion beats are a QRS complex with hybrid morphology of a sinus beat and an intraventricular beat resulting from impulses from two different locations activating the ventricle. One of the impulses is typically ventricular and the other is typically supraventricular.
  • Nitrate therapy works by reducing both the preload and afterload by dilating veins, coronary arteries, and systemic arteries. It works by relaxing vascular smooth muscles.
  • There are five cyanotic congenital heart lesions. Remember the 5 T’s and the 1-5 mnemonic: one for truncus arteriosus, two for transposition of the great vessels, three for tricuspid atresia, four for Tetrology of Fallot, and 5 for total anomalous pulmonary vascular return (TAPVR).

Now onto this week’s podcast

Question 1

Which of the following is the most common complication associated with an anterior shoulder dislocation?

A. Axillary nerve injury

B. Bankart lesion

C. Greater tuberosity fracture

D. Hill-Sachs defect

Teaching image

Question 2

A 35-year-old woman presents for evaluation of chest pain. The patient describes a burning pain that begins in the subxiphoid area and radiates up into her neck. Occasionally she has a bitter taste in her mouth. Her electrocardiogram and chest radiograph are normal. Which of the following is most likely to help her symptoms?

A. Avoidance of fatty foods

B. Calcium channel blocker therapy

C. Eradication of H. pylori

D. Head of bed elevation while sleeping

Teaching image

Question 3

You diagnose a 43-year-old patient with alcohol withdrawal. Lab studies reveal a hemoglobin of 8 g/dL and an MCV of 115. Which of the following is the most common cause of these findings

A. Chronic alcohol abuse

B. Pyridoxine deficiency

C. Thiamine deficiency

D. Vitamin B12 deficiency

Teaching image

Question 4

A 36-year-old woman with multiple sclerosis presents with progressive monocular vision loss over the preceding several hours. Which of the following exam findings would be expected?

A. Afferent pupillary defect

B. Diplopia on upward gaze

C. Hazy cornea

D. Sharp disc margins

Teaching image

Question 5

Which of the following statements is true regarding giant cell arteritis?

A. Aortic involvement can lead to valvular disease and dissection

B. Corticosteroid therapy should be initiated only when biopsy confirms the disease

C. Histologic findings of inflammation are irreversible

D. It is associated with sudden, painful binocular vision loss

Teaching image

Question 6

Which of the following describes a burn that causes pressure and discomfort, extends into the dermis, and may have thick-walled blisters or be leathery white?

A. First-degree burn

B. Second-degree deep partial-thickness burn

C. Second-degree superficial partial-thickness burn

D. Third-degree burn

Teaching image

That finishes off lucky Episode 13. We hope you enjoyed this week’s episode. Keep the feedback coming to Roshcast@roshreview.com, so we can tailor this podcast help it fit your learning habits. We will be skipping one week, so Jeff can enjoy his honeymoon!

Until next time,
Jeff and Nachi

P.S. If you missed last week’s episode including penile lesions, listen here.

By Nachi Gupta, M.D., Ph.D., and Megha Rajpal, M.D.

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