We are what we repeatedly do. Excellence, then, is not an act, but a habit.  -Aristotle Welcome back to RoshCast for Episode 41! As we get closer and closer to the in-training, now would be a great time to go back and listen to old episodes to brush up on some of the core EM knowledge that you may not come across regularly on shift. Let’s get started with a rapid review and our regular mixed content of questions, answers, and high-yield review. * Staph aureus is the most common bacterial cause of septic arthritis in adults. * In a patient with splenic dysfunction, the strep species are more likely to cause septic arthritis. * Septic arthritis classically presents with fever, monoarticular joint pain, and a decreased range of motion. * Joint aspirates with a white count > 50,000 with more than 75% PMNs are indicative of septic arthritis. Now onto this week’s podcast Question 1 Which of the following hematological disorders is characterized by intermittent venous and arterial thrombosis, splenomegaly, and abnormal proliferation of all three myeloid cell lines? A. Aplastic anemia B. Chronic myelogenous leukemia C. Disseminated intravascular coagulopathy D. Polycythemia vera Teaching Image  Question 2 Which of the following pairs are matched correctly? A. Elevated direct bilirubin – Gilbert’s syndrome B. Elevated indirect bilirubin – Cholestasis C. Elevated transaminases with ALT/AST ratio > 2:1 – Alcoholic hepatitis D. Elevated transaminases with AST and ALT > 10,000 IU/L – Ischemic hepatitis Teaching Image  Question 3 Which of the following conditions can result in refractory hypokalemia that is not correctable by the administration of potassium? A. Hypermagnesemia B. Hypernatremia C. Hypomagnesemia D. Hyponatremia Teaching Image Question 4 A 29-year-old male is brought to the ED for a gunshot wound to the right chest. He is diagnosed with a right-sided hemopneumothorax. A tube thoracostomy is subsequently performed with immediate drainage of 250 cc of blood. The nurse connects the chest tube to a commercial suction device, and a chest radiograph is performed that confirms proper placement. You note an absence of respiratory fluctuation of the fluid level in the drainage tube. A repeat chest X-ray shows the right-sided hemothorax remains. Which of the following is true regarding this finding? A. An air leak is present B. The lung is still collapsed C. There is a blockage of the drainage tube D. This is an expected finding Question 5 Which of the following is true regarding Ranson’s Criteria? A. A score of 0-3 on admission constitutes a high-risk population B. Glucose > 200 mg/dL on admission is associated with a higher mortality rate C. Hematocrit 35% at 48 hours is predictive of mortality D. WBC 10,000 is associated with a higher mortality rate Teaching Image  Question 6 The Emergency Medical Treatment and Active Labor Law of 1986, or EMTALA, requires hospitals to provide which of the following? A. Care to all patients B. Interpreters for all patients in a timely manner C.