{"id":2971,"date":"2018-10-30T11:21:46","date_gmt":"2018-10-30T15:21:46","guid":{"rendered":"https:\/\/www.roshreview.com\/?p=2971"},"modified":"2018-10-30T11:21:46","modified_gmt":"2018-10-30T15:21:46","slug":"podcast-ep-51-glioblastoma-kerion-antipsychotics-urine-dipstick-tetalogy-of-fallot-central-retinal-vein-occlusion","status":"publish","type":"post","link":"https:\/\/www.roshreview.com\/blog\/podcast-ep-51-glioblastoma-kerion-antipsychotics-urine-dipstick-tetalogy-of-fallot-central-retinal-vein-occlusion\/","title":{"rendered":"Podcast Ep 51: Glioblastoma, Kerion, Antipsychotics, Urine Dipstick, Tetalogy of Fallot, Central Retinal Vein Occlusion"},"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_51_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>A champion is defined not by their wins but by how they can recover when they fall.<\/p><cite>\u2013Serena Williams<\/cite><\/blockquote>\n\n\n\n<h6 class=\"wp-block-heading\">Welcome back to RoshCast for Episode 51!&nbsp;For those of you taking the initial certification exam, you&#8217;re at the home stretch. Remember to listen to this episode and old episodes as you get closer to the end for more review. Good luck from us at the RoshCast team! We have a great episode for you to get you prepped in your final studies!<\/h6>\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\">A 46-year-old man presents with a progressive dull headache over the past 3 weeks. It is worse in the morning and with bending over or coughing. He denies any fever or congestion. For the last two days, he has had associated nausea and three episodes of vomiting. Which of the following characteristics seen on neuroimaging would be most consistent with a glioblastoma?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A. Heterogenous mass with central necrosis<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">B. Lack of enhancement with administration of contrast<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">C. Presence of calcifications<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">D. Well circumscribed margins<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/Ep51-Glioblastoma-Multiforme.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 2<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A 16-year-old African American boy presents with a scalp rash. On examination, it is a 5 x 5 cm boggy and thickened area of the right parietal cap with an overlying scaly and crusty plaque and hair loss. The lesion appears yellowish-green under a Wood&#8217;s lamp. What is the treatment of choice for this lesion?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A. Clotrimazole ointment<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">B. Ketoconazole shampoo<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">C. Oral amphotericin B<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">D. Oral griseofulvin<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/Ep51-Kerion.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<p class=\"wp-block-paragraph\">A 22-year-old man recently diagnosed with schizophrenia presents to the ED with altered mental status. His blood pressure is 160\/80 mm Hg, pulse 130 beats per minute, and temperature is 39.5\u00b0C. He is noted to be confused and diaphoretic. He has muscle rigidity and a tremor in his hands. What is the most likely diagnosis?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A. Malignant hyperthermia<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">B. Neuroleptic malignant syndrome<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">C. Serotonin syndrome<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">D. Tyramine reaction<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/Ep51-NMS.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 4<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A 21-year-old woman presents with painful urination. She has no vaginal discharge and is not sexually active. Which of the following is most sensitive for a urinary tract infection on urine dipstick testing?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A. Bacteria<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">B. Blood<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">C. Leukocyte esterase<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">D. Nitrites<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/Ep51-Urinalysis.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 5<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Which of the following findings would be consistent with a diagnosis of tetralogy of Fallot?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A. Bounding pulses and a continuous machine-like murmur<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">B. Decreased pulses in lower extremities<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">C. Increased pulmonary vascular markings on chest radiography<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">D. Loud, single second heart sound with a harsh systolic murmur<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/Ep51-Tetralogy-of-Fallot.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<p class=\"wp-block-paragraph\">A 73-year-old man presents with painless vision loss in the right eye. Which of the following on funduscopic examination is most characteristic of central retinal vein occlusion?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A. Cherry red fovea<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">B. Pale retina<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">C. Papilledema<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">D. Retinal hemorrhages<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/Ep51-CRVO.png\">Teaching Image<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/Ep51-CRAO.png\">Teaching Image<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.roshreview.com\/wp-content\/uploads\/Ep51-Papilledema.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><span style=\"font-weight: 400\"><strong>Glioblastoma<\/strong> is the <strong>most common<\/strong> primary <strong>malignant brain tumor<\/strong> in adults and presents as a <strong>heterogeneous mass<\/strong> with <strong>central necrosis<\/strong>.<\/span><\/li><li><span style=\"font-weight: 400\"><\/span><span style=\"font-weight: 400\">A <strong>kerion<\/strong> is a <strong>boggy<\/strong>,<strong> pus-filled lesion<\/strong> caused by a <strong>fungal<\/strong> <strong>infection<\/strong> on the <strong>scalp<\/strong>. It is treated with a <strong>6 to 8-week<\/strong> course of oral <strong>griseofulvin<\/strong>.<\/span><\/li><li><span style=\"font-weight: 400\"><\/span><span style=\"font-weight: 400\"><strong>New antipsychotic<\/strong> medication administration and a presentation of <strong>altered mental status<\/strong>, <strong>muscle rigidity<\/strong>, <strong>hyperthermia<\/strong>, and <strong>autonomic instability<\/strong> is classic for the diagnosis of <strong>neuroleptic malignant syndrome<\/strong>.<\/span><\/li><li><span style=\"font-weight: 400\"><\/span><span style=\"font-weight: 400\">On urine dipstick, <strong>leukocyte esterase<\/strong> is <strong>sensitive<\/strong> while <strong>nitrites<\/strong> are <strong>specific<\/strong> for a urinary tract infection.<\/span><\/li><li><span style=\"font-weight: 400\"><\/span><span style=\"font-weight: 400\"><strong>Tetralogy of Fallot<\/strong> is the <strong>most common cyanotic<\/strong> <strong>congenital heart disease<\/strong> and is associated with a <strong>harsh systolic murmur<\/strong> that <strong>improves with squatting<\/strong>.<\/span><\/li><li><span style=\"font-weight: 400\"><\/span><span style=\"font-weight: 400\"><strong>Central retinal vein occlusion<\/strong> presents with <strong>sudden<\/strong>, <strong>painless<\/strong>, <strong>monocular<\/strong> <strong>vision loss<\/strong> with the classic \u201c<strong>blood and thunder<\/strong>\u201d appearance and <strong>retinal hemorrhages<\/strong>.<\/span><\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">That wraps up RoshCast Episode 51!&nbsp;Be sure to also check out the rest of the&nbsp;<a rel=\"noreferrer noopener\" aria-label=\" (opens in a new tab)\" href=\"https:\/\/www.roshreview.com\/blog\/\" target=\"_blank\">Rosh Review Blog<\/a>&nbsp;for questions from prior episodes, related images, and tables, and 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>. 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;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">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.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Megha and Nachi<\/p>\n","protected":false},"excerpt":{"rendered":"<p>A champion is defined not by their wins but by how they can recover when they fall. \u2013Serena Williams Welcome back to RoshCast for Episode 51!&nbsp;For those of you taking the initial certification exam, you&#8217;re at the home stretch. Remember to listen to this episode and old episodes as you get closer to the end <a href=\"https:\/\/www.roshreview.com\/blog\/podcast-ep-51-glioblastoma-kerion-antipsychotics-urine-dipstick-tetalogy-of-fallot-central-retinal-vein-occlusion\/\">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":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"categories":[2025,1999],"tags":[2170,2260,2292,2330,2349,2497,2724,2737,2927,2961,3112,3123,3161,3265,3400,3460,3615,3639,3718],"coauthors":[],"class_list":["post-2971","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-emergency-medicine","category-podcast","tag-antipsychotic","tag-blood-and-thunder","tag-brain-tumor","tag-cardiology","tag-central-retinal-vein-occlusion","tag-dermatology","tag-glioblastoma","tag-griseofulvin","tag-kerion","tag-leukocyte-esterase","tag-neuroleptic-malignant-syndrome","tag-nitrite","tag-ophthalmology","tag-pediatrics","tag-psychiatry","tag-retinal-hemorrhages","tag-systolic-murmur","tag-tetralogy-of-fallot","tag-urine-dipstick"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.4 (Yoast SEO v28.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Podcast Ep 51: Glioblastoma, Kerion, Antipsychotics, Urine Dipstick, Tetalogy of Fallot, Central Retinal Vein Occlusion - RoshReview.com<\/title>\n<meta name=\"description\" content=\"Welcome to RoshCast (Ep. 51), the first question and answer style emergency medicine podcast. 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