{"id":2656,"date":"2018-07-24T13:59:01","date_gmt":"2018-07-24T17:59:01","guid":{"rendered":"https:\/\/www.roshreview.com\/?p=2656"},"modified":"2018-07-24T13:59:01","modified_gmt":"2018-07-24T17:59:01","slug":"podcast-ep-43-pulmonary-embolism-colchicine-facial-paralysis-cervical-spine-injuries-blast-injuries-traumatic-iritis-2","status":"publish","type":"post","link":"https:\/\/www.roshreview.com\/blog\/podcast-ep-43-pulmonary-embolism-colchicine-facial-paralysis-cervical-spine-injuries-blast-injuries-traumatic-iritis-2\/","title":{"rendered":"Podcast Ep 44: Spider Bites, Biphasic T Waves, Lyme Disease, Syringomyelia, Wernicke Encephalopathy, Electrolyte Abnormalities"},"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_44_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>By failing to prepare, you are preparing to fail.<\/p><cite>\u2013Benjamin Franklin<\/cite><\/blockquote>\n\n\n\n<h6 class=\"wp-block-heading\">Welcome back to RoshCast for Episode 44! We are back to an every other week schedule covering core content. Let&#8217;s start out with a rapid review of neonatal conjunctivitis.<\/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=\"178\" height=\"66\" src=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/RapidReview_50.png\" alt=\"\" class=\"wp-image-1608\" \/><\/figure><\/div>\n\n\n\n<ul class=\"wp-block-list\"><li>The three dangerous causes of <strong>neonatal conjunctivitis<\/strong> that you need to consider in the ED are <strong>gonorrhea<\/strong>, <strong>chlamydia<\/strong>, and <strong>herpes<\/strong>.<\/li><li><strong>Gonorrhea<\/strong> is the <strong>most aggressive<\/strong> bacteria associated with neonatal conjunctivitis. It presents in the <strong>first week of life<\/strong> with <strong>purulent drainage and ulcerations<\/strong>, and it can <strong>disseminate to cause gonococcal sepsis<\/strong>. <strong>Culture<\/strong> the drainage for confirmation, and <strong>treat<\/strong> the baby with <strong>cefotaxime<\/strong>.<\/li><li><strong>Chlamydia<\/strong> <strong>neonatal conjunctivitis<\/strong>, which presents in the <strong>first month<\/strong> of life, can <strong>disseminate into the lungs<\/strong>. Treat with <strong>oral erythromycin<\/strong>.<\/li><li>The <strong>third and least dangerous<\/strong> cause of <strong>neonatal conjunctivitis<\/strong> is <strong>herpetic<\/strong>. In this case you may see <strong>vesicles in the eye<\/strong>. Treat this with <strong>IV acyclovir<\/strong>.<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><span><b>Now onto this week\u2019s podcast<\/b><\/span><\/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<div class=\"wp-block-image\"><figure class=\"aligncenter\"><img loading=\"lazy\" decoding=\"async\" width=\"411\" height=\"305\" src=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/Ep44-Brown-Recluse-Spider.png\" alt=\"\" class=\"wp-image-2666\" srcset=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/Ep44-Brown-Recluse-Spider.png 411w, https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/Ep44-Brown-Recluse-Spider-300x223.png 300w\" sizes=\"auto, (max-width: 411px) 100vw, 411px\" \/><\/figure><\/div>\n\n\n\n<p class=\"wp-block-paragraph\">A 21-year-old man presents after he was bitten by a spider. He has a picture of the spider on his phone (shown above). Which of the following is a potential complication of a bite by this spider?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A. Abdominal rigidity<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">B. Autonomic instability<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">C. Coagulation abnormalities<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">D. Pancreatitis<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/Ep44-Black-Widow-Brown-Recluse.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<div class=\"wp-block-image\"><figure class=\"aligncenter\"><img loading=\"lazy\" decoding=\"async\" width=\"800\" height=\"363\" src=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/Ep44-Wellens-EKG.jpg\" alt=\"\" class=\"wp-image-2669\" srcset=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/Ep44-Wellens-EKG.jpg 800w, https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/Ep44-Wellens-EKG-300x136.jpg 300w, https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/Ep44-Wellens-EKG-600x272.jpg 600w\" sizes=\"auto, (max-width: 800px) 100vw, 800px\" \/><\/figure><\/div>\n\n\n\n<p class=\"wp-block-paragraph\">A 66-year-old man with hypertension and hyperlipidemia presents after an episode of severe chest pain while walking to work. He is currently asymptomatic. His vitals are T 36.27\u00b0C, HR 76\/min, BP 143\/85 mm Hg, RR 18\/min, and oxygen saturation 99%. A 12-lead ECG is performed as seen above. Which of the following is the most appropriate next step in management?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A. Give 325 mg of aspirin, and activate the cardiac catheterization lab<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">B. Give 325 mg of aspirin, and admit for serial troponin testing and stress test<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">C. Give 325 mg of aspirin, and discharge home with cardiology follow-up in 24\u201348 hours<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">D. Send d-dimer, and consider CT pulmonary angiogram if elevated<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/Ep44-Wellens-Syndrome.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 3<\/strong><\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter\"><img loading=\"lazy\" decoding=\"async\" width=\"548\" height=\"353\" src=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/Ep44-Erythema-Migrans-Bells.jpg\" alt=\"\" class=\"wp-image-2667\" srcset=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/Ep44-Erythema-Migrans-Bells.jpg 548w, https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/Ep44-Erythema-Migrans-Bells-300x193.jpg 300w\" sizes=\"auto, (max-width: 548px) 100vw, 548px\" \/><\/figure><\/div>\n\n\n\n<p class=\"wp-block-paragraph\">A 17-year-old boy from New Jersey presents with a 3-day history of rash and a 1-day history of facial droop. He also complains of a headache. The images above represent the physical examination findings. In addition you note mild nuchal rigidity. A noncontrast head CT is performed and is normal. Which of the following is the next best step for this patient?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A. Acyclovir and corticosteroids<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">B. Lumbar puncture<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">C. MRI brain<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">D. Serologic testing for Lyme disease&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/Ep44-3-Stages-of-Lyme-Disease.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 52-year-old man presents with decreased sensation in the upper extremities and chronic neck pain. He states that the loss of sensation has been progressive for months. On physical examination, he has decreased sensation to pain over the upper back, shoulders, and arms with intact proprioception and light touch. What disorder does this patient exhibit?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A. Anterior cord syndrome<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">B. Brown-Sequard syndrome<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">C. Central cord syndrome<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">D. Syringomyelia<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/Ep44-Syrinomyelia.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 5<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">What is the most frequently seen oculomotor sign in patients with Wernicke encephalopathy?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A. Lateral nystagmus<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">B. Lateral rectus palsy<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">C. Miosis<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">D. Ptosis<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/Ep44-Wernicke-Syndrome.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 6<\/strong><\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter\"><img loading=\"lazy\" decoding=\"async\" width=\"650\" height=\"461\" src=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/Ep44-Short-QT-Hypercalcemia.jpg\" alt=\"\" class=\"wp-image-2668\" srcset=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/Ep44-Short-QT-Hypercalcemia.jpg 650w, https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/Ep44-Short-QT-Hypercalcemia-300x213.jpg 300w, https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/Ep44-Short-QT-Hypercalcemia-600x426.jpg 600w\" sizes=\"auto, (max-width: 650px) 100vw, 650px\" \/><\/figure><\/div>\n\n\n\n<p class=\"wp-block-paragraph\">A patient with metastatic breast cancer presents with weakness and nausea. An ECG is shown above. What electrolyte abnormality is likely in this patient?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A. Hypercalcemia<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">B. Hypernatremia<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">C. Hypocalcemia<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">D. Hyponatremia<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/Ep44-Hypercalcemia.jpg\">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=\"178\" height=\"66\" src=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/RapidReview_50.png\" alt=\"\" class=\"wp-image-1608\" \/><\/figure><\/div>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Brown recluse spiders<\/strong> have <strong>violin-shaped<\/strong> markings on their back. The toxin here can lead to <strong>hematologic abnormalities<\/strong>. There is no antivenin available in the US.<\/li><li><strong>Black widow spiders<\/strong>, on the other hand, have a <strong>red hourglass<\/strong> shape on their ventral surface and their toxin causes <strong>autonomic instability<\/strong> and <strong>abdominal wall rigidity<\/strong>. There is an antivenin available, but it\u2019s only used in severe cases.<\/li><li><strong>Wellen\u2019s syndrome type A<\/strong> demonstrates <strong>biphasic T waves in V1\u2013V3<\/strong> and <strong>type B<\/strong> demonstrates <strong>deeply inverted T waves in V1\u2013V3<\/strong>. &nbsp;It is highly specific for a <strong>critical<\/strong> <strong>stenosis of the LAD<\/strong>. Activate the <strong>catheterization lab<\/strong>!<\/li><li>There are three <strong>stages<\/strong> of <strong>Lyme disease<\/strong>: <ul><li><strong>Early Lyme<\/strong> manifests with the classic <strong>erythema migrans<\/strong> rash.<\/li><li>The <strong>second stage<\/strong> is <strong>acute disseminated infection<\/strong> which results in <strong>neurologic<\/strong>, <strong>cardiac<\/strong>, <strong>arthritic<\/strong>, and <strong>ophthalmic<\/strong> manifestations.<\/li><li>The <strong>third<\/strong> is <strong>late Lyme<\/strong> disease, which presents with <strong>worse neurologic manifestations<\/strong> and <strong>chronic Lyme arthritis<\/strong>. <\/li><\/ul><\/li><li>The <strong>most common location<\/strong> of <strong>syringomyelia<\/strong> is the <strong>cervical spine<\/strong>.&nbsp;Patients present with a <strong>cape-like distribution<\/strong> of <strong>loss of pain and temperature sensation in the upper extremities<\/strong> with preservation of light touch and proprioception.<\/li><li><strong>Anterior cord syndrome<\/strong> is characterized by <strong>loss of motor function below the lesion<\/strong> and preservation of position, touch, and vibration sensation.<\/li><li><strong>Brown-Sequard syndrome<\/strong> presents with <strong>ipsilateral motor function loss and contralateral pain and temperature sensation loss.<\/strong><\/li><li><strong>Central cord syndrome<\/strong> presents with <strong>bilateral motor paresis and sensory impairment<\/strong>.<\/li><li>The most frequently seen <strong>oculomotor sign<\/strong> in <strong>Wernicke encephalopathy<\/strong> is <strong>lateral nystagmus<\/strong>.<\/li><li>Diagnosis of <strong>Wernicke encephalopathy<\/strong> requires two out of four of the following criteria: <strong>dietary deficiencies<\/strong>, <strong>oculomotor dysfunction<\/strong>, <strong>cerebellar dysfunction<\/strong>, and <strong>altered mental status<\/strong>.<\/li><li><strong>Hypercalcemia<\/strong> can cause <strong>QT shortening,<\/strong> while hypocalcemia can cause QT prolongation.<\/li><li><strong>Malignancy<\/strong> is the <strong>most common<\/strong> <strong>inpatient cause of hypercalcemia<\/strong> while <strong>primary hyperparathyroidism<\/strong> is the <strong>most common outpatient cause<\/strong>.<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><span style=\"font-weight: 400\">That wraps up RoshCast Episode 44!&nbsp;Be sure to also check out the rest of the&nbsp;<\/span><a href=\"https:\/\/www.roshreview.com\/blog\/\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">Rosh Review Blog&nbsp;<\/a><span style=\"font-weight: 400\">for questions from prior episodes, related images and tables, as well as bonus teaching points. There are also tons of other great free resources to help prepare you for the boards and the wards. Don\u2019t forget to follow us on twitter <a href=\"https:\/\/twitter.com\/roshcast?lang=en\">@RoshCast<\/a>&nbsp;and <a href=\"https:\/\/twitter.com\/roshreview?lang=en\">@RoshReview<\/a>. And you can always email us at <a href=\"mailto:roshcast@roshreview.com\">RoshCast@RoshReview.com<\/a>&nbsp;with any feedback, corrections, or suggestions.&nbsp;<\/span><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><span style=\"font-weight: 400\">You can also help us pick questions by identifying ones you would like us to review. Write \u201cRoshCast\u201d in the submit feedback box as you go through the question bank. Lastly, if you have a minute, make sure to rate us and leave comments on <a href=\"https:\/\/itunes.apple.com\/us\/podcast\/roshcast\/id1156487141?mt=2\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\">iTunes<\/a>&nbsp;to help spread the word about RoshCast. We&#8217;re launching on Google Play in the near future also.<\/span><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><span style=\"font-weight: 400\">Megha and Nachi<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>By failing to prepare, you are preparing to fail. \u2013Benjamin Franklin Welcome back to RoshCast for Episode 44! We are back to an every other week schedule covering core content. Let&#8217;s start out with a rapid review of neonatal conjunctivitis. The three dangerous causes of neonatal conjunctivitis that you need to consider in the ED <a href=\"https:\/\/www.roshreview.com\/blog\/podcast-ep-43-pulmonary-embolism-colchicine-facial-paralysis-cervical-spine-injuries-blast-injuries-traumatic-iritis-2\/\">read more&#8230;<\/a><\/p>\n","protected":false},"author":11,"featured_media":2637,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"inline_featured_image":false,"footnotes":""},"categories":[2025,1999],"tags":[2042,2083,2125,2156,2206,2247,2252,2298,2301,2318,2330,2336,2341,2346,2353,2359,2375,2488,2511,2604,2615,2660,2661,2730,2731,2765,2790,2795,2831,2840,2937,2947,2991,2999,3105,3113,3153,3265,3375,3419,3426,3427,3444,3558,3614,3749,3754,3775,3776],"coauthors":[],"class_list":["post-2656","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-emergency-medicine","category-podcast","tag-abdominal-wall-rigidity","tag-acyclovir","tag-altered-mental-status","tag-anterior-cord-syndrome","tag-autonomic-instability","tag-biphasic-t-waves","tag-black-widow","tag-brown-recluse","tag-brown-sequard-syndrome","tag-cape-like-distribution","tag-cardiology","tag-cath-lab","tag-cefotaxime","tag-central-cord-syndrome","tag-cerebellar-dysfunction","tag-cervical-spine","tag-chlamydia","tag-deeply-inverted-t-waves","tag-dietary-deficiencies","tag-environmental","tag-erythema-migrans","tag-first-month-of-life","tag-first-week-of-life","tag-gonococcal-sepsis","tag-gonorrhea","tag-hematologic-abnormalities","tag-herpes","tag-herpetic","tag-hypercalcemia","tag-hypocalcemia","tag-lad","tag-lateral-nystagmus","tag-lyme-disease","tag-malignancy","tag-neonatal-conjunctivitis","tag-neurology","tag-oculomotor-dysfunction","tag-pediatrics","tag-primary-hyperparathyroidism","tag-purulent-drainage","tag-qt-prolongation","tag-qt-shortening","tag-red-hourglass","tag-spider-bites","tag-syringomyelia","tag-vesicles","tag-violin-shaped","tag-wellens-syndrome","tag-wernickes-encephalopathy"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.2 (Yoast SEO v28.2) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Podcast Ep 44: Spider Bites, Biphasic T Waves, Lyme Disease, Syringomyelia, Wernicke Encephalopathy, Electrolyte Abnormalities - RoshReview.com<\/title>\n<meta name=\"description\" content=\"Welcome to RoshCast (Ep. 44), 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\/podcast-ep-43-pulmonary-embolism-colchicine-facial-paralysis-cervical-spine-injuries-blast-injuries-traumatic-iritis-2\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Podcast Ep 44: Spider Bites, Biphasic T Waves, Lyme Disease, Syringomyelia, Wernicke Encephalopathy, Electrolyte Abnormalities\" \/>\n<meta property=\"og:description\" content=\"Welcome to RoshCast (Ep. 44), the first question and answer style emergency medicine podcast. Listen and learn more.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.roshreview.com\/blog\/podcast-ep-43-pulmonary-embolism-colchicine-facial-paralysis-cervical-spine-injuries-blast-injuries-traumatic-iritis-2\/\" \/>\n<meta property=\"og:site_name\" content=\"RoshReview.com\" \/>\n<meta property=\"article:published_time\" content=\"2018-07-24T17:59:01+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/IMG_0033.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"1024\" \/>\n\t<meta property=\"og:image:height\" content=\"800\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\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\":\"Article\",\"@id\":\"https:\\\/\\\/www.roshreview.com\\\/blog\\\/podcast-ep-43-pulmonary-embolism-colchicine-facial-paralysis-cervical-spine-injuries-blast-injuries-traumatic-iritis-2\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.roshreview.com\\\/blog\\\/podcast-ep-43-pulmonary-embolism-colchicine-facial-paralysis-cervical-spine-injuries-blast-injuries-traumatic-iritis-2\\\/\"},\"author\":{\"name\":\"Nachi Gupta, M.D., Ph.D., and Megha Rajpal, M.D.\",\"@id\":\"https:\\\/\\\/www.roshreview.com\\\/blog\\\/#\\\/schema\\\/person\\\/a838e825547ab58f0be77d446d19338a\"},\"headline\":\"Podcast Ep 44: Spider Bites, Biphasic T Waves, Lyme Disease, Syringomyelia, Wernicke Encephalopathy, Electrolyte Abnormalities\",\"datePublished\":\"2018-07-24T17:59:01+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/www.roshreview.com\\\/blog\\\/podcast-ep-43-pulmonary-embolism-colchicine-facial-paralysis-cervical-spine-injuries-blast-injuries-traumatic-iritis-2\\\/\"},\"wordCount\":993,\"commentCount\":0,\"image\":{\"@id\":\"https:\\\/\\\/www.roshreview.com\\\/blog\\\/podcast-ep-43-pulmonary-embolism-colchicine-facial-paralysis-cervical-spine-injuries-blast-injuries-traumatic-iritis-2\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/www.roshreview.com\\\/wp-content\\\/uploads\\\/sites\\\/2\\\/IMG_0033.jpg\",\"keywords\":[\"abdominal wall rigidity\",\"acyclovir\",\"altered mental status\",\"Anterior cord syndrome\",\"autonomic instability\",\"biphasic T waves\",\"black widow\",\"brown recluse\",\"brown-sequard syndrome\",\"cape-like distribution\",\"cardiology\",\"Cath lab\",\"cefotaxime\",\"central cord syndrome\",\"cerebellar dysfunction\",\"cervical spine\",\"Chlamydia\",\"deeply inverted T waves\",\"dietary deficiencies\",\"environmental\",\"Erythema migrans\",\"first month of life\",\"first week of life\",\"gonococcal sepsis\",\"Gonorrhea\",\"hematologic abnormalities\",\"herpes\",\"herpetic\",\"hypercalcemia\",\"hypocalcemia\",\"LAD\",\"lateral nystagmus\",\"lyme disease\",\"malignancy\",\"neonatal conjunctivitis\",\"neurology\",\"oculomotor dysfunction\",\"pediatrics\",\"primary hyperparathyroidism\",\"purulent drainage\",\"qt prolongation\",\"qt shortening\",\"red hourglass\",\"spider bites\",\"syringomyelia\",\"vesicles\",\"violin-shaped\",\"Wellens syndrome\",\"wernicke's encephalopathy\"],\"articleSection\":[\"Emergency Medicine\",\"Podcast\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/www.roshreview.com\\\/blog\\\/podcast-ep-43-pulmonary-embolism-colchicine-facial-paralysis-cervical-spine-injuries-blast-injuries-traumatic-iritis-2\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.roshreview.com\\\/blog\\\/podcast-ep-43-pulmonary-embolism-colchicine-facial-paralysis-cervical-spine-injuries-blast-injuries-traumatic-iritis-2\\\/\",\"url\":\"https:\\\/\\\/www.roshreview.com\\\/blog\\\/podcast-ep-43-pulmonary-embolism-colchicine-facial-paralysis-cervical-spine-injuries-blast-injuries-traumatic-iritis-2\\\/\",\"name\":\"Podcast Ep 44: Spider Bites, Biphasic T Waves, Lyme Disease, Syringomyelia, Wernicke Encephalopathy, Electrolyte Abnormalities - RoshReview.com\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.roshreview.com\\\/blog\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/www.roshreview.com\\\/blog\\\/podcast-ep-43-pulmonary-embolism-colchicine-facial-paralysis-cervical-spine-injuries-blast-injuries-traumatic-iritis-2\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/www.roshreview.com\\\/blog\\\/podcast-ep-43-pulmonary-embolism-colchicine-facial-paralysis-cervical-spine-injuries-blast-injuries-traumatic-iritis-2\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/www.roshreview.com\\\/wp-content\\\/uploads\\\/sites\\\/2\\\/IMG_0033.jpg\",\"datePublished\":\"2018-07-24T17:59:01+00:00\",\"author\":{\"@id\":\"https:\\\/\\\/www.roshreview.com\\\/blog\\\/#\\\/schema\\\/person\\\/a838e825547ab58f0be77d446d19338a\"},\"description\":\"Welcome to RoshCast (Ep. 44), the first question and answer style emergency medicine podcast. Listen and learn more.\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/www.roshreview.com\\\/blog\\\/podcast-ep-43-pulmonary-embolism-colchicine-facial-paralysis-cervical-spine-injuries-blast-injuries-traumatic-iritis-2\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/www.roshreview.com\\\/blog\\\/podcast-ep-43-pulmonary-embolism-colchicine-facial-paralysis-cervical-spine-injuries-blast-injuries-traumatic-iritis-2\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/www.roshreview.com\\\/blog\\\/podcast-ep-43-pulmonary-embolism-colchicine-facial-paralysis-cervical-spine-injuries-blast-injuries-traumatic-iritis-2\\\/#primaryimage\",\"url\":\"https:\\\/\\\/www.roshreview.com\\\/wp-content\\\/uploads\\\/sites\\\/2\\\/IMG_0033.jpg\",\"contentUrl\":\"https:\\\/\\\/www.roshreview.com\\\/wp-content\\\/uploads\\\/sites\\\/2\\\/IMG_0033.jpg\",\"width\":1024,\"height\":800},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/www.roshreview.com\\\/blog\\\/podcast-ep-43-pulmonary-embolism-colchicine-facial-paralysis-cervical-spine-injuries-blast-injuries-traumatic-iritis-2\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/www.roshreview.com\\\/blog\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Podcast Ep 44: Spider Bites, Biphasic T Waves, Lyme Disease, Syringomyelia, Wernicke Encephalopathy, Electrolyte Abnormalities\"}]},{\"@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:\\\/\\\/secure.gravatar.com\\\/avatar\\\/977f46ed31103df4f8dedd47070baa8fcb56b3e1b9e412217d7e5fbb642dd210?s=96&d=mm&r=g75849d0b5b168ef11fedd98d7b20b2f4\",\"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 44: Spider Bites, Biphasic T Waves, Lyme Disease, Syringomyelia, Wernicke Encephalopathy, Electrolyte Abnormalities - RoshReview.com","description":"Welcome to RoshCast (Ep. 44), 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\/podcast-ep-43-pulmonary-embolism-colchicine-facial-paralysis-cervical-spine-injuries-blast-injuries-traumatic-iritis-2\/","og_locale":"en_US","og_type":"article","og_title":"Podcast Ep 44: Spider Bites, Biphasic T Waves, Lyme Disease, Syringomyelia, Wernicke Encephalopathy, Electrolyte Abnormalities","og_description":"Welcome to RoshCast (Ep. 44), the first question and answer style emergency medicine podcast. Listen and learn more.","og_url":"https:\/\/www.roshreview.com\/blog\/podcast-ep-43-pulmonary-embolism-colchicine-facial-paralysis-cervical-spine-injuries-blast-injuries-traumatic-iritis-2\/","og_site_name":"RoshReview.com","article_published_time":"2018-07-24T17:59:01+00:00","og_image":[{"width":1024,"height":800,"url":"https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/IMG_0033.jpg","type":"image\/jpeg"}],"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":"Article","@id":"https:\/\/www.roshreview.com\/blog\/podcast-ep-43-pulmonary-embolism-colchicine-facial-paralysis-cervical-spine-injuries-blast-injuries-traumatic-iritis-2\/#article","isPartOf":{"@id":"https:\/\/www.roshreview.com\/blog\/podcast-ep-43-pulmonary-embolism-colchicine-facial-paralysis-cervical-spine-injuries-blast-injuries-traumatic-iritis-2\/"},"author":{"name":"Nachi Gupta, M.D., Ph.D., and Megha Rajpal, M.D.","@id":"https:\/\/www.roshreview.com\/blog\/#\/schema\/person\/a838e825547ab58f0be77d446d19338a"},"headline":"Podcast Ep 44: Spider Bites, Biphasic T Waves, Lyme Disease, Syringomyelia, Wernicke Encephalopathy, Electrolyte Abnormalities","datePublished":"2018-07-24T17:59:01+00:00","mainEntityOfPage":{"@id":"https:\/\/www.roshreview.com\/blog\/podcast-ep-43-pulmonary-embolism-colchicine-facial-paralysis-cervical-spine-injuries-blast-injuries-traumatic-iritis-2\/"},"wordCount":993,"commentCount":0,"image":{"@id":"https:\/\/www.roshreview.com\/blog\/podcast-ep-43-pulmonary-embolism-colchicine-facial-paralysis-cervical-spine-injuries-blast-injuries-traumatic-iritis-2\/#primaryimage"},"thumbnailUrl":"https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/IMG_0033.jpg","keywords":["abdominal wall rigidity","acyclovir","altered mental status","Anterior cord syndrome","autonomic instability","biphasic T waves","black widow","brown recluse","brown-sequard syndrome","cape-like distribution","cardiology","Cath lab","cefotaxime","central cord syndrome","cerebellar dysfunction","cervical spine","Chlamydia","deeply inverted T waves","dietary deficiencies","environmental","Erythema migrans","first month of life","first week of life","gonococcal sepsis","Gonorrhea","hematologic abnormalities","herpes","herpetic","hypercalcemia","hypocalcemia","LAD","lateral nystagmus","lyme disease","malignancy","neonatal conjunctivitis","neurology","oculomotor dysfunction","pediatrics","primary hyperparathyroidism","purulent drainage","qt prolongation","qt shortening","red hourglass","spider bites","syringomyelia","vesicles","violin-shaped","Wellens syndrome","wernicke's encephalopathy"],"articleSection":["Emergency Medicine","Podcast"],"inLanguage":"en-US","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/www.roshreview.com\/blog\/podcast-ep-43-pulmonary-embolism-colchicine-facial-paralysis-cervical-spine-injuries-blast-injuries-traumatic-iritis-2\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/www.roshreview.com\/blog\/podcast-ep-43-pulmonary-embolism-colchicine-facial-paralysis-cervical-spine-injuries-blast-injuries-traumatic-iritis-2\/","url":"https:\/\/www.roshreview.com\/blog\/podcast-ep-43-pulmonary-embolism-colchicine-facial-paralysis-cervical-spine-injuries-blast-injuries-traumatic-iritis-2\/","name":"Podcast Ep 44: Spider Bites, Biphasic T Waves, Lyme Disease, Syringomyelia, Wernicke Encephalopathy, Electrolyte Abnormalities - RoshReview.com","isPartOf":{"@id":"https:\/\/www.roshreview.com\/blog\/#website"},"primaryImageOfPage":{"@id":"https:\/\/www.roshreview.com\/blog\/podcast-ep-43-pulmonary-embolism-colchicine-facial-paralysis-cervical-spine-injuries-blast-injuries-traumatic-iritis-2\/#primaryimage"},"image":{"@id":"https:\/\/www.roshreview.com\/blog\/podcast-ep-43-pulmonary-embolism-colchicine-facial-paralysis-cervical-spine-injuries-blast-injuries-traumatic-iritis-2\/#primaryimage"},"thumbnailUrl":"https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/IMG_0033.jpg","datePublished":"2018-07-24T17:59:01+00:00","author":{"@id":"https:\/\/www.roshreview.com\/blog\/#\/schema\/person\/a838e825547ab58f0be77d446d19338a"},"description":"Welcome to RoshCast (Ep. 44), the first question and answer style emergency medicine podcast. Listen and learn more.","breadcrumb":{"@id":"https:\/\/www.roshreview.com\/blog\/podcast-ep-43-pulmonary-embolism-colchicine-facial-paralysis-cervical-spine-injuries-blast-injuries-traumatic-iritis-2\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.roshreview.com\/blog\/podcast-ep-43-pulmonary-embolism-colchicine-facial-paralysis-cervical-spine-injuries-blast-injuries-traumatic-iritis-2\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/www.roshreview.com\/blog\/podcast-ep-43-pulmonary-embolism-colchicine-facial-paralysis-cervical-spine-injuries-blast-injuries-traumatic-iritis-2\/#primaryimage","url":"https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/IMG_0033.jpg","contentUrl":"https:\/\/www.roshreview.com\/wp-content\/uploads\/sites\/2\/IMG_0033.jpg","width":1024,"height":800},{"@type":"BreadcrumbList","@id":"https:\/\/www.roshreview.com\/blog\/podcast-ep-43-pulmonary-embolism-colchicine-facial-paralysis-cervical-spine-injuries-blast-injuries-traumatic-iritis-2\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/www.roshreview.com\/blog\/"},{"@type":"ListItem","position":2,"name":"Podcast Ep 44: Spider Bites, Biphasic T Waves, Lyme Disease, Syringomyelia, Wernicke Encephalopathy, Electrolyte Abnormalities"}]},{"@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:\/\/secure.gravatar.com\/avatar\/977f46ed31103df4f8dedd47070baa8fcb56b3e1b9e412217d7e5fbb642dd210?s=96&d=mm&r=g75849d0b5b168ef11fedd98d7b20b2f4","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\/2656","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=2656"}],"version-history":[{"count":0,"href":"https:\/\/www.roshreview.com\/blog\/wp-json\/wp\/v2\/posts\/2656\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.roshreview.com\/blog\/wp-json\/wp\/v2\/media\/2637"}],"wp:attachment":[{"href":"https:\/\/www.roshreview.com\/blog\/wp-json\/wp\/v2\/media?parent=2656"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.roshreview.com\/blog\/wp-json\/wp\/v2\/categories?post=2656"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.roshreview.com\/blog\/wp-json\/wp\/v2\/tags?post=2656"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/www.roshreview.com\/blog\/wp-json\/wp\/v2\/coauthors?post=2656"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}