{"id":1204,"date":"2017-02-02T09:19:02","date_gmt":"2017-02-02T14:19:02","guid":{"rendered":"https:\/\/www.roshreview.com\/?p=1204"},"modified":"2017-02-02T09:19:02","modified_gmt":"2017-02-02T14:19:02","slug":"ep-14-otitis-media-hemophilia-pelvic-inflammatory-disease-strep-pharyngitis-frostbite-balanitis","status":"publish","type":"post","link":"https:\/\/www.roshreview.com\/blog\/ep-14-otitis-media-hemophilia-pelvic-inflammatory-disease-strep-pharyngitis-frostbite-balanitis\/","title":{"rendered":"Podcast Ep 14: Otitis Media, Hemophilia, Frostbite, &amp; More"},"content":{"rendered":"\n<figure class=\"wp-block-audio\"><audio controls src=\"https:\/\/media.blubrry.com\/roshcast\/content.blubrry.com\/roshcast\/Ep_14_Roshcast_Emergency_Board_Review.mp3\"><\/audio><\/figure>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\"><p>If opportunity doesn&#8217;t knock, build a door. &nbsp; <\/p><cite>-Milton Berle<\/cite><\/blockquote>\n\n\n\n<h6 class=\"wp-block-heading\">Welcome back to Episode 14! After a short break for Jeff\u2019s honeymoon, we are back this week with more high-quality review. We have weekly episodes in the works to keep you motivated. Take note of a small change to the format this week: after each question, you will hear a one-second pause to contemplate the answer or to pause the podcast to give you even more time. We made this change in response to listener feedback; keep more feedback coming to <a href=\"mailto:Roshcast@roshreview.com\">Roshcast@roshreview.com<\/a>.&nbsp;<\/h6>\n\n\n\n<hr class=\"wp-block-separator\" \/>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>We have one more exciting change to announce this week.<\/strong> As you go through the <a href=\"https:\/\/www.roshreview.com\/specialties\/emergency-medicine\/\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"Rosh Review EM question bank (opens in a new tab)\">Rosh Review EM question bank<\/a> and you come across a difficult question or a question you think would be perfect for Roshcasting, <span style=\"text-decoration: underline\">hit the \u201csubmit feedback\u201d button and type \u201cRoshcast.\u201d<\/span><\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter\"><img loading=\"lazy\" decoding=\"async\" width=\"500\" height=\"531\" src=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/Feedback-1.png\" alt=\"Submit feedback\" class=\"wp-image-1208\" srcset=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/Feedback-1.png 500w, https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/Feedback-1-282x300.png 282w\" sizes=\"auto, (max-width: 500px) 100vw, 500px\" \/><\/figure><\/div>\n\n\n\n<p class=\"wp-block-paragraph\">This will prompt the feedback to alert us, and we will work on incorporating the question as quickly as possible. Let\u2019s get started with this week\u2019s episode.<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter\"><img loading=\"lazy\" decoding=\"async\" width=\"201\" height=\"74\" src=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/RapidReview-2-e1475624722961.png\" alt=\"Rapid review\" class=\"wp-image-818\" \/><\/figure><\/div>\n\n\n\n<ul class=\"wp-block-list\"><li>The <strong>Hill-Sachs<\/strong> defect (a <strong>depression fracture of the posterolateral surface of the humeral head<\/strong>) is the most common complication of an <strong>anterior shoulder dislocation<\/strong>. It is seen in about 40% of cases.<\/li><li><strong>Fight bites<\/strong> should be treated with orally with <strong>amoxicillin-clavulanate<\/strong> to cover <strong>Eikenella<\/strong> If the patient requires IV antibiotics, ampicillin-sulbactam, cefoxitin, or piperacillin-tazobactam can be administered.<\/li><li><strong>Nursemaid\u2019s elbow<\/strong> can be reduced by <strong>supination followed by flexion<\/strong> or by <strong>hyperpronation<\/strong>. X-rays are not routinely required.<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Now onto this week\u2019s podcast<\/strong><\/p>\n\n\n\n<hr class=\"wp-block-separator\" \/>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Question 1<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Which of the following signs has the greatest likelihood ratio for acute otitis media?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><span>A. Impaired mobility of the tympanic membrane<\/span><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><span>B. Red tympanic membrane<\/span><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><span>C. Retracted tympanic membrane<\/span><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><span>D. Ruptured tympanic membrane<\/span><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/Table-Acute-otitis-media-diagnosis.jpg\">Teaching image<\/a><\/p>\n\n\n\n<hr class=\"wp-block-separator\" \/>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Question 2<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A 4-year-old boy with hemophilia A presents to the ED after he fell from the monkey bars and struck his head on the ground. On exam, he has a large occipital hematoma and a GCS of 14. Which of the following should be administered?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><span>A. Cryoprecipitate<\/span><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><span>B. Factor IX concentrate<\/span><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><span>C. Factor VIII concentrate<\/span><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><span>D. Recombinant human factor VIIa<\/span><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/Image-Hemophilia-factor-VIII-Replacement.png\">Teaching image&nbsp;<\/a><\/p>\n\n\n\n<hr class=\"wp-block-separator\" \/>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Question 3<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A 22-year-old woman presents with lower abdominal pain and abnormal vaginal discharge for 4 days. She is sexually active with multiple partners and does not consistently use barrier contraception. She has bilateral adnexal tenderness and yellow discharge on pelvic exam. Her urine pregnancy test is negative. In addition to a 1-time dose of ceftriaxone, what is the appropriate outpatient course of antibiotics for the patient?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><span>A. Azithromycin 1 gram PO x 1<\/span><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><span>B. Ciprofloxacin 500 mg PO BID x 14 days<\/span><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><span>C. Doxycycline 100 mg PO BID x 14 days<\/span><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><span>D. Metronidazole 500 mg PO BID x 14 days<\/span><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/Image-Pelvic-Inflammatory-Disease-PID.png\">Teaching image<\/a><\/p>\n\n\n\n<hr class=\"wp-block-separator\" \/>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Question 4<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A 6-year-old boy presents with a fever of 38.5\u00b0C, sore throat, and tender anterior cervical adenopathy. He does not have a cough or a runny nose. His younger sister was treated for<span>&nbsp;<\/span><em>streptococcal<\/em><span>&nbsp;<\/span>pharyngitis last week and his mother would like him to be treated for<span>&nbsp;<\/span><em>streptococcal<\/em><span>&nbsp;<\/span>infection. According to the modified Centor criteria, which of the following is the most appropriate action?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><span>A. Empiric antibiotic treatment for&nbsp;streptococcal&nbsp;pharyngitis&nbsp;<\/span><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><span>B. Rapid antigen detection testing<\/span><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><span>C. Streptococcal&nbsp;antibody titers<\/span><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><span>D. Tonsillectomy when he recovers from this infection<\/span><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/Image-Centor-Criteria.jpg\">Teaching image<strong>&nbsp;<\/strong><\/a><\/p>\n\n\n\n<hr class=\"wp-block-separator\" \/>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Question 5<\/strong><strong>&nbsp;<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A 48-year-old homeless man is brought in by EMS. He has been walking outside in the snow for many hours wearing only tennis shoes. He is complaining that he is unable to feel his feet. On examination, his feet are cold to the touch, whitish in color, and swollen. He has delayed capillary refill and multiple clear, fluid-filled bullae on his toes. Which of the following is the most appropriate thawing technique?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><span>A. Water immersion at temperatures between 35\u201336\u00b0C<\/span><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><span>B. Water immersion at temperatures between 37\u201339\u00b0C<\/span><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><span>C. Water immersion at temperatures between 40\u201342\u00b0C&nbsp;<\/span><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><span>D. Water immersion at temperatures between 43\u201345\u00b0C<\/span><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/Table-Frostbite.png\">Teaching image&nbsp;<\/a><\/p>\n\n\n\n<hr class=\"wp-block-separator\" \/>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Question 6<\/strong><\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter\"><img loading=\"lazy\" decoding=\"async\" width=\"150\" height=\"150\" src=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/Image-Balanitis-150x150.jpg\" alt=\"\" class=\"wp-image-1214\" srcset=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/Image-Balanitis-150x150.jpg 150w, https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/Image-Balanitis-300x300.jpg 300w, https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/Image-Balanitis-100x100.jpg 100w\" sizes=\"auto, (max-width: 150px) 100vw, 150px\" \/><\/figure><\/div>\n\n\n\n<p class=\"wp-block-paragraph\">A 19-year-old man with diabetes presents with penile pain and dysuria. Physical examination of the penis reveals the image above. The patient states he has had similar episodes in the past. What management is indicated?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><span>A. Azithromycin and ceftriaxone<\/span><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><span>B. Ciprofloxacin<\/span><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><span>C. Clotrimazole cream<\/span><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><span>D. Hydrocortisone cream<\/span><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/Image-Balanitis-Balanoposthitis.png\">Teaching image<\/a><\/p>\n\n\n\n<hr class=\"wp-block-separator\" \/>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter\"><img loading=\"lazy\" decoding=\"async\" width=\"201\" height=\"74\" src=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/RapidReview-2-e1475624722961.png\" alt=\"Rapid review\" class=\"wp-image-818\" \/><\/figure><\/div>\n\n\n\n<ul class=\"wp-block-list\"><li><strong><a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"\/tag\/acute-otitis-media\" target=\"_blank\">Acute otitis media<\/a><\/strong> is most commonly caused <strong><a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"\/tag\/viral-pathogens\" target=\"_blank\">viral pathogens<\/a><\/strong>. In cases of bacterial infection, <em>Streptococcus<\/em>, <em>Haemophilus<\/em>, and <em>Moraxella<\/em> are the three most common causes. The treatment is amoxicillin.<\/li><li>In <strong><a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"\/tag\/otitis-media\" target=\"_blank\">otitis media<\/a><\/strong>, a <strong><a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"\/tag\/cloudy-tympanic-membrane\" target=\"_blank\">cloudy tympanic membrane<\/a><\/strong>&nbsp;has a likelihood ratio of 34 and <strong><a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"\/tag\/impaired-mobility-of-the-tympanic-membrane\" target=\"_blank\">impaired mobility of the tympanic membrane<\/a><\/strong>&nbsp;has a likelihood ratio of 31. A red tympanic membrane has a likelihood ratio of 2.<\/li><li><strong><a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"\/tag\/hemophilia-a\" target=\"_blank\">Hemophilia A<\/a><\/strong> is caused by decreased synthesis of <strong><a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"\/tag\/factor-viii\" target=\"_blank\">factor VIII<\/a>. <a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"\/tag\/hemophilia-b\" target=\"_blank\">Hemophilia B<\/a><\/strong>&nbsp;or Christmas disease is caused by decreased synthesis of <strong><a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"\/tag\/factor-ix\" target=\"_blank\">factor IX<\/a><\/strong>.<\/li><li>Both <strong><a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"\/tag\/hemophilia\" target=\"_blank\">hemophilia<\/a><\/strong>&nbsp;A and B are <strong><a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"\/tag\/x-linked-recessive-diseases\" target=\"_blank\">X-linked recessive diseases<\/a><\/strong>.<\/li><li><strong><a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"\/tag\/hemophilia \" target=\"_blank\">Hemophilia <\/a><\/strong>A is treated with factor VIII replacement and Hemophilia B is treated with factor IX supplementation. Alternatively, <strong>cryoprecipitate can also be used in cases of shortages<\/strong>.<\/li><li><strong><a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"\/tag\/pid\" target=\"_blank\">PID<\/a><\/strong> is typically caused by <strong><a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"\/tag\/gonorrhea \" target=\"_blank\">gonorrhea <\/a>or<a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"\/tag\/chlamydia\" target=\"_blank\"> chlamydia<\/a> or both<\/strong>. It is treated with <strong><a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"\/tag\/ceftriaxone\" target=\"_blank\">ceftriaxone<\/a>&nbsp;250 mg IM<\/strong> once and <strong><a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"\/tag\/doxycycline\" target=\"_blank\">doxycycline<\/a>&nbsp;100 mg PO BID x 14 days<\/strong> if the patient can tolerate PO. Do not confuse PID with the more benign cervicitis, which is treated with ceftriaxone and a single dose of 1 gram of azithromycin.<\/li><li><strong><a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"\/tag\/fitz-hugh-curtis-syndrome\" target=\"_blank\">Fitz-Hugh-Curtis syndrome<\/a><\/strong> is a<a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"\/tag\/perihepatitis\" target=\"_blank\"> <\/a><strong><a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"\/tag\/perihepatitis\" target=\"_blank\">perihepatitis<\/a><\/strong> <strong>associated with PID<\/strong>. It is a difficult diagnosis to make, but suspect it in those with both <strong>pelvic and right upper quadrant pain<\/strong>.<\/li><li>In the <strong><a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"\/tag\/modified-centor-score\" target=\"_blank\">Modified<\/a><\/strong><a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"\/tag\/modified-centor-score\" target=\"_blank\"> <\/a><strong><a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"\/tag\/modified-centor-score\" target=\"_blank\">Centor Score<\/a><\/strong>, you get one point for<strong> <a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"\/tag\/tonsillar-exudates\" target=\"_blank\">tonsillar exudates<\/a><\/strong>, one point for <strong>tender anterior cervical adenopathy<\/strong>, one point <strong>fever by history<\/strong>, one point for the&nbsp;<strong>absence of cough<\/strong>, and one point for <strong>age less than 15<\/strong> <strong>years old<\/strong>. For an <strong>age over 45, you subtract one point.<\/strong><\/li><li>In the <strong><a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"\/tag\/modified-centor-score\" target=\"_blank\">Modified<\/a><\/strong><a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"\/tag\/modified-centor-score\" target=\"_blank\"> <\/a><strong><a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"\/tag\/modified-centor-score\" target=\"_blank\">Centor Score<\/a><\/strong>, for a score of <strong>0 or 1 points, treat supportively<\/strong>; <strong>2 or 3 points, test and treat if positive<\/strong>; and <strong>4 or 5 points, empirically treat<\/strong>. The mainstay of treatment is <strong><a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"\/tag\/amoxicillin\" target=\"_blank\">amoxicillin<\/a><\/strong>.<\/li><li><strong><a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"\/tag\/frostbite\" target=\"_blank\">Frostbite<\/a><\/strong> should be treated with<strong> <a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"\/tag\/immersion\" target=\"_blank\">immersion<\/a><\/strong>&nbsp;in a warm water bath at <strong>37 to 39 degrees Celsius<\/strong>. Water at higher temperature will warm no faster and cause increased pain and potentially tissue damage.<\/li><li><strong><a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"\/tag\/balanitis\" target=\"_blank\">Balanitis<\/a><\/strong> is a <strong><a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"\/tag\/fungal-infection\" target=\"_blank\">fungal infection<\/a><\/strong>&nbsp;of the <strong><a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"\/tag\/glans\" target=\"_blank\">glans<\/a><\/strong>&nbsp;typically caused by a candida infection. Treatment is with <strong><a href=\"\/tag\/clotrimazole-cream\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">clotrimazole cream<\/a><\/strong>.<\/li><\/ul>\n\n\n\n<hr class=\"wp-block-separator\" \/>\n\n\n\n<p class=\"wp-block-paragraph\">Hope you enjoyed this week\u2019s episode. Keep studying and reviewing daily. We will be back next week with more high-yield review.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><span>If you missed last week\u2019s episode including temporal arteritis, <\/span><a href=\"https:\/\/www.roshreview.com\/podcasts\/ep-13-shoulder-dislocations-gerd-ethanol-abuse-multiple-sclerosis-temporal-arteritis-burns\/\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">listen here<\/a><span>.<\/span><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Until next time,<br>Jeff and Nachi<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">P.S. Check out this blog post about <a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"https:\/\/www.roshreview.com\/blog\/elite-test-taker-profile-ryan-ribeira-m-d-m-p-h-2\/\" target=\"_blank\">elite test-taking tips<\/a> with Dr. Robert Hughes<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Welcome back to Episode 14! After a short break for Jeff\u2019s honeymoon, we are back this week with more high-quality review. We have weekly episodes in the works to keep you motivated. Take note of a small change to the format this week &#8211; after each question, you will hear a one-second pause to contemplate the answer or to pause the podcast to give you even more time. We made this change in response to listener feedback; keep more feedback coming to Roshcast@roshreview.com. <\/p>\n","protected":false},"author":11,"featured_media":1205,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"categories":[2025,1999],"tags":[2080,2138,2218,2342,2344,2375,2393,2395,2532,2636,2637,2662,2684,2686,2722,2731,2774,2775,2776,2858,2863,2970,3054,3173,3268,3285,3297,3312,3663,3756],"coauthors":[],"class_list":["post-1204","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-emergency-medicine","category-podcast","tag-acute-otitis-media","tag-amoxicillin","tag-balanitis","tag-ceftriaxone","tag-centor","tag-chlamydia","tag-clotrimazole-cream","tag-cloudy-tympanic-membrane","tag-doxycycline","tag-factor-ix","tag-factor-viii","tag-fitz-hugh-curtis-syndrome","tag-frostbite","tag-fungal-infection","tag-glans","tag-gonorrhea","tag-hemophilia","tag-hemophilia-a","tag-hemophilia-b","tag-immersion","tag-impaired-mobility-of-the-tympanic-membrane","tag-likelihood-ratio","tag-modified-centor-score","tag-otitis-media","tag-pelvic-inflammatory-disease","tag-perihepatitis","tag-pharyngitis","tag-pid","tag-tonsillar-exudates","tag-viral-pathogens"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.4 (Yoast SEO v28.6) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Podcast Ep 14: Otitis Media, Hemophilia, Frostbite &amp; More| RoshReview.com<\/title>\n<meta name=\"description\" content=\"Welcome to RoshCast (Ep. 14), the first question and answer style emergency medicine podcast. Listen and learn more.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.roshreview.com\/blog\/ep-14-otitis-media-hemophilia-pelvic-inflammatory-disease-strep-pharyngitis-frostbite-balanitis\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Podcast Ep 14: Otitis Media, Hemophilia, Frostbite, &amp; More\" \/>\n<meta property=\"og:description\" content=\"Welcome to RoshCast (Ep. 14), the first question and answer style emergency medicine podcast. 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