The secret of change is to focus all of your energy, not on fighting the old, but on building the new.  -Socrates Welcome back to RoshCast for Episode 42! With the in-training exam around the corner, go back and power through old episodes during commutes to pick up as many points as possible. Good luck! * Patent ductus arteriosus (or PDA) closes, the neonate will present in heart failure and shock. * Turner’s Syndrome is associated with Coarctation. Turner’s is also associated with webbed neck, short stature, and low-set ears. * Individuals with Turner’s syndrome are missing an X chromosome as well, making it a 45 XO chromosomal condition. * A blood pressure differential between the arms and legs — specifically, the pressure in the arms is higher than the legs. Depending on the specific anatomy, you might even note a difference in the pressures between both arms. * Classic EKG and chest x-ray findings associated with coarctation of the aorta include left ventricular hypertrophy and rib notching, respectively. Now onto this week’s podcast Question 1 Which of the following is typically seen in Korsakoff syndrome? A. Cerebellar dysfunction B. Long-term memory impairment C. Ophthalmoplegia D. Recent memory impairment Teaching Image  Question 2 Which of the following is the most common physical exam finding in an abdominal aortic aneurysm? A. Abdominal bruit B. Diminished femoral pulses C. Duodenal obstruction D. Pulsatile abdominal mass Teaching Image Question 3 A 24-year-old woman at full term presents with rupture of membranes and contractions. Sterile exam reveals a crowning infant with a visible cord. After elevating the fetal head, what management is indicated? A. Clamp and cut cord and proceed with delivery B. Continue with standard delivery C. Emergent cesarean section D. Intravenous tocolytics Teaching Image  Question 4 You suspect a 35-year-old man has epiglottitis with impending airway compromise. Which of the following is the best method for confirming the diagnosis? A. Computed tomography of the neck B. Frontal cervical soft tissue radiograph C. Indirect laryngoscopy D. Lateral cervical soft tissue radiograph Teaching Image Question 5 A 21-year-old man presents with a stab wound to the right chest. His vitals are HR 157, BP 81/43, RR 28, and oxygen saturation 91%. The patient is intubated and packed red blood cells are started. Physical examination reveals a bleeding wound to the right chest, a midline trachea and decreased breath sounds on auscultation of the right hemithorax. Which of the following should be performed next? A. Application of a pelvic binder B. Placement of a right thoracostomy tube C. Right chest thoracotomy D. Transfer to operating room Teaching Image  Question 6 A 65-year-old man with a history of hypertension presents with left sided weakness beginning two hours prior to arrival. Vitals are BP 155/85 mm Hg, HR 102, RR 12, oxygen saturation 100% on RA. His CT scan is shown above. Which of the following therapies is appropriate? A.