{"id":1423,"date":"2017-04-19T22:34:37","date_gmt":"2017-04-20T02:34:37","guid":{"rendered":"https:\/\/www.roshreview.com\/?p=1423"},"modified":"2017-04-19T22:34:37","modified_gmt":"2017-04-20T02:34:37","slug":"ep-22-pneumothorax-vaginal-bleeding-high-pressure-injection-injuries-dive-medicine-pjp-pneumonia-subungual-hematomas","status":"publish","type":"post","link":"https:\/\/www.roshreview.com\/blog\/ep-22-pneumothorax-vaginal-bleeding-high-pressure-injection-injuries-dive-medicine-pjp-pneumonia-subungual-hematomas\/","title":{"rendered":"Podcast Ep 22: Pneumothorax, Vaginal Bleeding, &amp; More"},"content":{"rendered":"\n<figure class=\"wp-block-audio\"><audio controls src=\"https:\/\/media.blubrry.com\/thereveal\/s\/media.blubrry.com\/roshcast\/s\/content.blubrry.com\/roshcast\/Ep_22_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>No matter what people tell you, words and ideas can change the world. &nbsp; <\/p><cite>-Robin Williams<\/cite><\/blockquote>\n\n\n\n<h6 class=\"wp-block-heading\">Welcome back to Episode 22! This week, we have some bread-and-butter emergency medicine with a lot of deeper learning points, so pay close attention as you listen through. Let\u2019s start out with a review of pediatrics before we jump into the new material.<\/h6>\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=\"\" class=\"wp-image-818\" \/><\/figure><\/div>\n\n\n\n<ul class=\"wp-block-list\"><li>In treating <strong>epiglottitis<\/strong>, the first priority is <strong>airway management<\/strong>. Once the airway has been secured, it can be treated with either <strong>ampicillin-sulbactam or ceftriaxone<\/strong>.<\/li><li>The five<strong> congenital cyanotic heart defects<\/strong> can be remembered with the numbers 1 to 5. <ul><li>One for <strong>trucus arteriosus<\/strong> in which the two vessels join to make one.<\/li><li>Two for <strong>transposition of the great vessels<\/strong> in which the two great vessels are switched.<\/li><li>Three for <strong>tricuspid atresia<\/strong>, remember three for tricuspid.<\/li><li>Four for the four defects of <strong>tetralogy of Fallot<\/strong>.<\/li><li>Five for the five words in <strong>total anomalous pulmonary vascular return<\/strong>. <\/li><\/ul><\/li><li>The three common <strong>acyanotic heart lesions<\/strong> are <strong>atrial septal defects<\/strong>, <strong>ventricular septal defects<\/strong>, and <strong>patent ductus arteriosus<\/strong><\/li><\/ul>\n\n\n\n<p><strong>Now onto this week\u2019s podcast<\/strong><\/p>\n\n\n\n<hr class=\"wp-block-separator\" \/>\n\n\n\n<p><strong>Question 1<\/strong><\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter\"><img loading=\"lazy\" decoding=\"async\" width=\"444\" height=\"477\" src=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/Image-Tension-PTX.jpg\" alt=\"\" class=\"wp-image-1430\" srcset=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/Image-Tension-PTX.jpg 444w, https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/Image-Tension-PTX-279x300.jpg 279w\" sizes=\"auto, (max-width: 444px) 100vw, 444px\" \/><\/figure><\/div>\n\n\n\n<p>A 19-year-old woman presents with acute onset of shortness of breath and chest pain. The patient\u2019s chest X-ray is shown above. Which of the following provides definitive management for the condition?<\/p>\n\n\n\n<p>A. Chest thoracostomy tube<\/p>\n\n\n\n<p>B. Intubation and mechanical ventilation<\/p>\n\n\n\n<p>C. Needle decompression<\/p>\n\n\n\n<p>D. Percutaneous pigtail catheter placement<\/p>\n\n\n\n<p><a href=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/X-ray-Tension-pneumothorax-Needle-decompression-needle-thoracostomy.png\" target=\"_blank\" rel=\"noopener noreferrer\">Teaching Image<\/a><\/p>\n\n\n\n<hr class=\"wp-block-separator\" \/>\n\n\n\n<p><strong>Question 2<\/strong><\/p>\n\n\n\n<p>A 25-year-old 36-week pregnant woman presents to the ED with a complaint of vaginal bleeding. She denies associated cramping, abdominal pain, or preceding traumatic event. She describes the blood as \u201cbright red.\u201d Which of the following is a risk factor for the development of this condition?<\/p>\n\n\n\n<p><span>A. Previous caesarean section&nbsp;<\/span><\/p>\n\n\n\n<p><span>B. Previous ectopic pregnancy<\/span><\/p>\n\n\n\n<p><span>C. Primiparity<\/span><\/p>\n\n\n\n<p><span>D. Young maternal age<\/span><\/p>\n\n\n\n<p><a href=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/Image-Placenta-previa.png\" target=\"_blank\" rel=\"noopener noreferrer\">Teaching Image<\/a><\/p>\n\n\n\n<hr class=\"wp-block-separator\" \/>\n\n\n\n<p><strong>Question 3<\/strong><\/p>\n\n\n\n<p>An 18-year-old man presents with an injury to his left index finger. The patient was cleaning the nozzle of a high-pressure paint injector when it fired and punctured his finger. The patient reports pain at the site. On exam, you note a small puncture wound and no exit wound. There is no erythema and the site is mildly tender to palpation. Plain films do not demonstrate a fracture. Which of the following is the most appropriate next step in management?<span>&nbsp;<\/span><\/p>\n\n\n\n<p><span>A. Consult a hand surgeon<\/span><\/p>\n\n\n\n<p><span>B. Perform a digital block for wound exploration<\/span><\/p>\n\n\n\n<p><span>C. Perform high-pressure syringe irrigation<\/span><\/p>\n\n\n\n<p><span>D. Place a sugar-tong splint for immobilization<\/span><\/p>\n\n\n\n<p><a href=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/Image-High-Pressure-Injection-Injury-of-the-Hand.png\">Teaching image<\/a><\/p>\n\n\n\n<hr class=\"wp-block-separator\" \/>\n\n\n\n<p><strong>Question 4<\/strong><\/p>\n\n\n\n<p>A scuba diver returns to the surface and is unconscious. Which of the following is the likely diagnosis?<\/p>\n\n\n\n<p><span>A. Air embolism<\/span><\/p>\n\n\n\n<p><span>B. Bends<\/span><\/p>\n\n\n\n<p><span>C. Cerebral edema<\/span><\/p>\n\n\n\n<p><span>D. Nitrogen narcosis<\/span><\/p>\n\n\n\n<p><a href=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/Image-Arterial-Gas-Embolism-Barotrauma.png\" target=\"_blank\" rel=\"noopener noreferrer\">Teaching Image<\/a><\/p>\n\n\n\n<hr class=\"wp-block-separator\" \/>\n\n\n\n<p><strong>Question 5<\/strong><\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter\"><img loading=\"lazy\" decoding=\"async\" width=\"344\" height=\"397\" src=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/Image-PJP-Pneumonia.jpg\" alt=\"\" class=\"wp-image-1427\" srcset=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/Image-PJP-Pneumonia.jpg 344w, https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/Image-PJP-Pneumonia-260x300.jpg 260w\" sizes=\"auto, (max-width: 344px) 100vw, 344px\" \/><\/figure><\/div>\n\n\n\n<p>A 34-year-old woman with HIV presents with a cough and shortness of breath. Her oxygen saturation is 93% on room air, partial arterial oxygen tension of 75 mm Hg, and A-a gradient of 30 mm Hg. Her chest X-ray is shown above. What treatment is indicated?<\/p>\n\n\n\n<p><span>A. Azithromycin and outpatient follow-up<\/span><\/p>\n\n\n\n<p><span>B. Bronchodilators and corticosteroids<\/span><\/p>\n\n\n\n<p><span>C. Doxycycline<\/span><\/p>\n\n\n\n<p><span>D. Trimethoprim-sulfamethoxazole (TMP-SMX)<\/span><\/p>\n\n\n\n<p><a href=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/Image-PCP-Pneumonia-Pneumocystis-Pneumocystis-jiroveci-Pneumonia.png\">Teaching file<\/a><\/p>\n\n\n\n<hr class=\"wp-block-separator\" \/>\n\n\n\n<p><strong>Question 6<\/strong><\/p>\n\n\n\n<p>A 16-year-old girl presents with pain to the right index finger after slamming it in a car door. Physical examination reveals a 50% subungual hematoma, and an X-ray shows a nondisplaced distal tuft fracture. What management is indicated?<\/p>\n\n\n\n<p>A. Oral antibiotics, splinting, and follow-up<\/p>\n\n\n\n<p>B. Splinting and follow-up<\/p>\n\n\n\n<p>C. Trephination, splinting, and follow-up<\/p>\n\n\n\n<p>D. Trephination, splinting, oral antibiotics, and follow-up<\/p>\n\n\n\n<p><a href=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/Video-Nail-trephinaiton-for-subungual-hematoma.mov\">Teaching Video<\/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=\"\" class=\"wp-image-818\" \/><\/figure><\/div>\n\n\n\n<ul class=\"wp-block-list\"><li>A <strong>tension pneumothorax<\/strong> may be managed <strong>immediately<\/strong> with <strong>needle decompression<\/strong>. <strong>Definitive management<\/strong> is with <strong>chest tube placement<\/strong>.<\/li><li>In patients with a <strong>pneumothorax<\/strong> <strong>more than a few days old<\/strong>, <strong>rapid re-expansion<\/strong> of the lung can lead to <strong>re-expansion pulmonary edema<\/strong>.<\/li><li><strong>Placenta previa<\/strong> is caused by <strong>placental implantation<\/strong> in the <strong>lower uterine segment<\/strong>, either completely or partially <strong>overlying the cervical OS<\/strong>.<\/li><li><strong>Placenta previa<\/strong> typically causes <strong>painless, bright red vaginal bleeding<\/strong> in the <strong>2nd or 3rd trimester<\/strong>. The abdominal exam will be benign.<\/li><li><strong>Risk factors<\/strong> for <strong>placenta previa<\/strong> include <strong>prior caesarean section<\/strong>, <strong>advanced maternal age<\/strong>, <strong>grand multiparity<\/strong>, <strong>previous placenta previa<\/strong>, multiple gestations, previous multiple induced abortions, and preterm labor.<\/li><li><strong>High-pressure injection injuries<\/strong> should be treated with <strong>broad-spectrum antibiotics<\/strong>, <strong>extremity elevation<\/strong>, and <strong>hand surgery consultation<\/strong>. They carry significant morbidity with delayed treatment leading to tissue necrosis, infection, and possible amputation.<\/li><li>Suspect an <strong>air embolism<\/strong> whenever any <strong>diver loses consciousness<\/strong> upon ascent or within 10 minutes of surfacing.<\/li><li><strong>Air embolisms<\/strong> can cause a wide range of symptoms, including <strong>stroke-like symptoms<\/strong>, <strong>dyspnea<\/strong>, <strong>hemoptysis<\/strong>, <strong>chest pain<\/strong>, and <strong>dysrhythmias<\/strong>. They are treated with <strong>hyperbaric recompression<\/strong>.<\/li><li><strong>Nitrogen narcosis<\/strong> occurs in dives <strong>beyond 100 feet<\/strong> due to an increased concentration of dissolved nitrogen. Symptoms including <strong>impaired motor function<\/strong> <strong>and behavior problems<\/strong>.<\/li><li>The <strong>bends<\/strong> is a dysbarism that occurs due to <strong>rapid ascent<\/strong>. It presents with <strong>diffuse muscle and joint pain due<\/strong> to nitrogen bubble release into the tissues.<\/li><li><strong>PJP Pneumonia<\/strong> is associated with <strong>diffuse interstitial infiltrates<\/strong>, classically in a <strong>bat<\/strong> <strong>wing appearance<\/strong>. It is treated with <strong>trimethoprim-sulfamethoxazole<\/strong>. If the arterial oxygen tension is less than 70 or the a-a gradient is greater than 35, corticosteroids have been shown to reduce mortality.<\/li><li><strong>Histoplasmosis<\/strong> is found in the <strong>Ohio<\/strong> <strong>and Mississippi river valleys<\/strong> and is associated with <strong>bird and bat droppings<\/strong>.<\/li><li><strong>Blastomycosis<\/strong> is found in the <strong>southeast US<\/strong>. In addition to pneumonia, it can cause <strong>bone<\/strong> <strong>lesions<\/strong>.<\/li><li><strong>Coccidioidomycosis<\/strong> is found in the <strong>southwest US<\/strong>. It is associated with <strong>erythema<\/strong> <strong>nodosum<\/strong> and <strong>arthritis<\/strong>.<\/li><li><strong>Legionella pneumonia<\/strong> is associated with <strong>hyponatremia<\/strong> and <strong>gastrointestinal symptoms<\/strong>.<\/li><li><strong>Distal tuft fractures<\/strong> are treated with <strong>nail trephination (if indicated), splinting, and follow up<\/strong>.<\/li><li><strong>Nail trephination<\/strong> can be accomplished with a <strong>heated 18-gauge needle or paperclip, or with an electrical cautery device<\/strong>. <strong>A single hole<\/strong> usually adequately <strong>relieves the pressure<\/strong> with the evacuation of a drop or two of blood.<\/li><\/ul>\n\n\n\n<p>That wraps up Episode 22. Remember to follow us on Twitter <a href=\"https:\/\/twitter.com\/Roshcast\">@Roshcast<\/a> for updates and high yield EM pearls in 140 characters or less. Curious about the data driving Rosh Review? Check out Sean Michael\u2019s <a rel=\"noreferrer noopener\" aria-label=\"post (opens in a new tab)\" href=\"https:\/\/www.roshreview.com\/blog\/specialties\/emergency-medicine\/unlocking-the-data-behind-rosh-review-to-improve-educational-outcomes-part-1\/\" target=\"_blank\">post<\/a> to get an inside look at the data and the educational philosophy at Rosh Review. Hope to see some of you at CORD!<\/p>\n\n\n\n<p>Until next time,<br>Jeff and Nachi<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Welcome back to Episode 22! This week, we have some bread-and-butter emergency medicine with a lot of deeper learning points, so pay close attention as you listen through. Let\u2019s start out with a review of pediatrics before we jump into the new material.<\/p>\n","protected":false},"author":11,"featured_media":1432,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"inline_featured_image":false,"footnotes":""},"categories":[2025,1999],"tags":[2092,2109,2192,2232,2257,2313,2367,2368,2408,2450,2524,2546,2547,2617,2750,2777,2804,2809,2810,2830,2846,2923,2958,3067,3072,3088,3099,3124,3150,3316,3317,3327,3330,3411,3414,3632,3647,3689,3726],"coauthors":[],"class_list":["post-1423","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-emergency-medicine","category-podcast","tag-advanced-maternal-age","tag-air-embolism","tag-arthritis","tag-bends","tag-blastomycosis","tag-caesarean-section","tag-chest-pain","tag-chest-tubes","tag-coccidiodomycosis","tag-corticosteroids","tag-dive-medicine","tag-dyspnea","tag-dysrhythmia","tag-erythema-nodosum","tag-hand-surgery","tag-hemoptysis","tag-high-pressure-injury","tag-histoplasmosis","tag-hiv","tag-hyperbaric-recompression","tag-hyponatremia","tag-joint-pain","tag-legionella","tag-multiparity","tag-muscle-aches","tag-nail-trephination","tag-needle-decompression","tag-nitrogen-narcosis","tag-obstetrics","tag-pjp-pneumonia","tag-placenta-previa","tag-pneumonia","tag-pneumothorax","tag-pulmonary-edema","tag-pulmonology","tag-tension-pneumothorax","tag-thoracostomy","tag-tuft-fracture","tag-vaginal-bleeding"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v21.7 (Yoast SEO v26.6) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Podcast Ep 22: Pneumothorax, Vaginal Bleeding &amp; More | RoshReview.com<\/title>\n<meta name=\"description\" content=\"Welcome to RoshCast (Ep. 22), 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-22-pneumothorax-vaginal-bleeding-high-pressure-injection-injuries-dive-medicine-pjp-pneumonia-subungual-hematomas\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Podcast Ep 22: Pneumothorax, Vaginal Bleeding, &amp; More\" \/>\n<meta property=\"og:description\" content=\"Welcome to RoshCast (Ep. 22), the first question and answer style emergency medicine podcast. Listen and learn more.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.roshreview.com\/blog\/ep-22-pneumothorax-vaginal-bleeding-high-pressure-injection-injuries-dive-medicine-pjp-pneumonia-subungual-hematomas\/\" \/>\n<meta property=\"og:site_name\" content=\"RoshReview.com\" \/>\n<meta property=\"article:published_time\" content=\"2017-04-20T02:34:37+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/EP22.png\" \/>\n\t<meta property=\"og:image:width\" content=\"518\" \/>\n\t<meta property=\"og:image:height\" content=\"344\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"author\" content=\"Nachi Gupta, M.D., Ph.D., and Megha Rajpal, M.D.\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Nachi Gupta, M.D., Ph.D., and Megha Rajpal, M.D.\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"5 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.roshreview.com\/blog\/ep-22-pneumothorax-vaginal-bleeding-high-pressure-injection-injuries-dive-medicine-pjp-pneumonia-subungual-hematomas\/\",\"url\":\"https:\/\/www.roshreview.com\/blog\/ep-22-pneumothorax-vaginal-bleeding-high-pressure-injection-injuries-dive-medicine-pjp-pneumonia-subungual-hematomas\/\",\"name\":\"Podcast Ep 22: Pneumothorax, Vaginal Bleeding & More | RoshReview.com\",\"isPartOf\":{\"@id\":\"https:\/\/www.roshreview.com\/blog\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/www.roshreview.com\/blog\/ep-22-pneumothorax-vaginal-bleeding-high-pressure-injection-injuries-dive-medicine-pjp-pneumonia-subungual-hematomas\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/www.roshreview.com\/blog\/ep-22-pneumothorax-vaginal-bleeding-high-pressure-injection-injuries-dive-medicine-pjp-pneumonia-subungual-hematomas\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/EP22.png\",\"datePublished\":\"2017-04-20T02:34:37+00:00\",\"author\":{\"@id\":\"https:\/\/www.roshreview.com\/blog\/#\/schema\/person\/a838e825547ab58f0be77d446d19338a\"},\"description\":\"Welcome to RoshCast (Ep. 22), the first question and answer style emergency medicine podcast. Listen and learn more.\",\"breadcrumb\":{\"@id\":\"https:\/\/www.roshreview.com\/blog\/ep-22-pneumothorax-vaginal-bleeding-high-pressure-injection-injuries-dive-medicine-pjp-pneumonia-subungual-hematomas\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/www.roshreview.com\/blog\/ep-22-pneumothorax-vaginal-bleeding-high-pressure-injection-injuries-dive-medicine-pjp-pneumonia-subungual-hematomas\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/www.roshreview.com\/blog\/ep-22-pneumothorax-vaginal-bleeding-high-pressure-injection-injuries-dive-medicine-pjp-pneumonia-subungual-hematomas\/#primaryimage\",\"url\":\"https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/EP22.png\",\"contentUrl\":\"https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/EP22.png\",\"width\":518,\"height\":344,\"caption\":\"Rosh Cast Episode 22\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/www.roshreview.com\/blog\/ep-22-pneumothorax-vaginal-bleeding-high-pressure-injection-injuries-dive-medicine-pjp-pneumonia-subungual-hematomas\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/www.roshreview.com\/blog\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Podcast Ep 22: Pneumothorax, Vaginal Bleeding, &amp; More\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/www.roshreview.com\/blog\/#website\",\"url\":\"https:\/\/www.roshreview.com\/blog\/\",\"name\":\"RoshReview.com\",\"description\":\"Free Powerful Rosh Content - Find content that fits you\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/www.roshreview.com\/blog\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"https:\/\/www.roshreview.com\/blog\/#\/schema\/person\/a838e825547ab58f0be77d446d19338a\",\"name\":\"Nachi Gupta, M.D., Ph.D., and Megha Rajpal, M.D.\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/www.roshreview.com\/blog\/#\/schema\/person\/image\/75849d0b5b168ef11fedd98d7b20b2f4\",\"url\":\"https:\/\/secure.gravatar.com\/avatar\/977f46ed31103df4f8dedd47070baa8fcb56b3e1b9e412217d7e5fbb642dd210?s=96&d=mm&r=g\",\"contentUrl\":\"https:\/\/secure.gravatar.com\/avatar\/977f46ed31103df4f8dedd47070baa8fcb56b3e1b9e412217d7e5fbb642dd210?s=96&d=mm&r=g\",\"caption\":\"Nachi Gupta, M.D., Ph.D., and Megha Rajpal, M.D.\"},\"description\":\"Nachi Gupta, MD PhD and Megha Rajpal, MD are emergency physicians with an interest in medical education. They are trying to make the world better one question at a time. Both reside in New York City.\",\"sameAs\":[\"https:\/\/www.roshreview.com\/author\/nachigupta\"],\"url\":\"https:\/\/www.roshreview.com\/blog\/author\/nachigupta\/\"}]}<\/script>\n<!-- \/ Yoast SEO Premium plugin. -->","yoast_head_json":{"title":"Podcast Ep 22: Pneumothorax, Vaginal Bleeding & More | RoshReview.com","description":"Welcome to RoshCast (Ep. 22), the first question and answer style emergency medicine podcast. Listen and learn more.","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.roshreview.com\/blog\/ep-22-pneumothorax-vaginal-bleeding-high-pressure-injection-injuries-dive-medicine-pjp-pneumonia-subungual-hematomas\/","og_locale":"en_US","og_type":"article","og_title":"Podcast Ep 22: Pneumothorax, Vaginal Bleeding, &amp; More","og_description":"Welcome to RoshCast (Ep. 22), the first question and answer style emergency medicine podcast. Listen and learn more.","og_url":"https:\/\/www.roshreview.com\/blog\/ep-22-pneumothorax-vaginal-bleeding-high-pressure-injection-injuries-dive-medicine-pjp-pneumonia-subungual-hematomas\/","og_site_name":"RoshReview.com","article_published_time":"2017-04-20T02:34:37+00:00","og_image":[{"width":518,"height":344,"url":"https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/EP22.png","type":"image\/png"}],"author":"Nachi Gupta, M.D., Ph.D., and Megha Rajpal, M.D.","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Nachi Gupta, M.D., Ph.D., and Megha Rajpal, M.D.","Est. reading time":"5 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/www.roshreview.com\/blog\/ep-22-pneumothorax-vaginal-bleeding-high-pressure-injection-injuries-dive-medicine-pjp-pneumonia-subungual-hematomas\/","url":"https:\/\/www.roshreview.com\/blog\/ep-22-pneumothorax-vaginal-bleeding-high-pressure-injection-injuries-dive-medicine-pjp-pneumonia-subungual-hematomas\/","name":"Podcast Ep 22: Pneumothorax, Vaginal Bleeding & More | RoshReview.com","isPartOf":{"@id":"https:\/\/www.roshreview.com\/blog\/#website"},"primaryImageOfPage":{"@id":"https:\/\/www.roshreview.com\/blog\/ep-22-pneumothorax-vaginal-bleeding-high-pressure-injection-injuries-dive-medicine-pjp-pneumonia-subungual-hematomas\/#primaryimage"},"image":{"@id":"https:\/\/www.roshreview.com\/blog\/ep-22-pneumothorax-vaginal-bleeding-high-pressure-injection-injuries-dive-medicine-pjp-pneumonia-subungual-hematomas\/#primaryimage"},"thumbnailUrl":"https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/EP22.png","datePublished":"2017-04-20T02:34:37+00:00","author":{"@id":"https:\/\/www.roshreview.com\/blog\/#\/schema\/person\/a838e825547ab58f0be77d446d19338a"},"description":"Welcome to RoshCast (Ep. 22), the first question and answer style emergency medicine podcast. Listen and learn more.","breadcrumb":{"@id":"https:\/\/www.roshreview.com\/blog\/ep-22-pneumothorax-vaginal-bleeding-high-pressure-injection-injuries-dive-medicine-pjp-pneumonia-subungual-hematomas\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.roshreview.com\/blog\/ep-22-pneumothorax-vaginal-bleeding-high-pressure-injection-injuries-dive-medicine-pjp-pneumonia-subungual-hematomas\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/www.roshreview.com\/blog\/ep-22-pneumothorax-vaginal-bleeding-high-pressure-injection-injuries-dive-medicine-pjp-pneumonia-subungual-hematomas\/#primaryimage","url":"https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/EP22.png","contentUrl":"https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/EP22.png","width":518,"height":344,"caption":"Rosh Cast Episode 22"},{"@type":"BreadcrumbList","@id":"https:\/\/www.roshreview.com\/blog\/ep-22-pneumothorax-vaginal-bleeding-high-pressure-injection-injuries-dive-medicine-pjp-pneumonia-subungual-hematomas\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/www.roshreview.com\/blog\/"},{"@type":"ListItem","position":2,"name":"Podcast Ep 22: Pneumothorax, Vaginal Bleeding, &amp; More"}]},{"@type":"WebSite","@id":"https:\/\/www.roshreview.com\/blog\/#website","url":"https:\/\/www.roshreview.com\/blog\/","name":"RoshReview.com","description":"Free Powerful Rosh Content - Find content that fits you","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.roshreview.com\/blog\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Person","@id":"https:\/\/www.roshreview.com\/blog\/#\/schema\/person\/a838e825547ab58f0be77d446d19338a","name":"Nachi Gupta, M.D., Ph.D., and Megha Rajpal, M.D.","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/www.roshreview.com\/blog\/#\/schema\/person\/image\/75849d0b5b168ef11fedd98d7b20b2f4","url":"https:\/\/secure.gravatar.com\/avatar\/977f46ed31103df4f8dedd47070baa8fcb56b3e1b9e412217d7e5fbb642dd210?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/977f46ed31103df4f8dedd47070baa8fcb56b3e1b9e412217d7e5fbb642dd210?s=96&d=mm&r=g","caption":"Nachi Gupta, M.D., Ph.D., and Megha Rajpal, M.D."},"description":"Nachi Gupta, MD PhD and Megha Rajpal, MD are emergency physicians with an interest in medical education. They are trying to make the world better one question at a time. Both reside in New York City.","sameAs":["https:\/\/www.roshreview.com\/author\/nachigupta"],"url":"https:\/\/www.roshreview.com\/blog\/author\/nachigupta\/"}]}},"_links":{"self":[{"href":"https:\/\/www.roshreview.com\/blog\/wp-json\/wp\/v2\/posts\/1423","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.roshreview.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.roshreview.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.roshreview.com\/blog\/wp-json\/wp\/v2\/users\/11"}],"replies":[{"embeddable":true,"href":"https:\/\/www.roshreview.com\/blog\/wp-json\/wp\/v2\/comments?post=1423"}],"version-history":[{"count":0,"href":"https:\/\/www.roshreview.com\/blog\/wp-json\/wp\/v2\/posts\/1423\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.roshreview.com\/blog\/wp-json\/wp\/v2\/media\/1432"}],"wp:attachment":[{"href":"https:\/\/www.roshreview.com\/blog\/wp-json\/wp\/v2\/media?parent=1423"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.roshreview.com\/blog\/wp-json\/wp\/v2\/categories?post=1423"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.roshreview.com\/blog\/wp-json\/wp\/v2\/tags?post=1423"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/www.roshreview.com\/blog\/wp-json\/wp\/v2\/coauthors?post=1423"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}