Believe you can and you’re halfway there. -Theodore Roosevelt Welcome back to Roshcast Episode 38, the last episode of 2018! Before we jump into this week’s episode, we have a few people to recognize. First, congrats to Zain who won the trauma ring tone challenge last episode and will be receiving a Rosh Review subscription. Special mention goes out as well to Clark, David, and Ryker who all responded soon after Zain. We should also recognize Sarah, who won the EM Clerkship-RoshCast crossover challenge and won a free copy of Case Files Emergency Medicine. Stay tuned for more contests to come! Let’s head back to the Rosh Blog and start out with a recent Rapid Review. * Central cord usually presents with sensory and motor deficits, with the upper extremities being affected more than the lower extremities. It’s most commonly caused by an extension injury. * Anterior cord syndrome presents with complete loss of motor, pain, and temperature below the level of the injury, but you would retain proprioception and vibration sensation. Anterior cord is most often caused by a flexion or vascular injury. * Brown Sequard classically occurs after penetrating trauma. It results in ipsilateral loss of motor, vibration, and proprioception with contralateral loss of pain and temperature. Now onto this week’s podcast Question 1 A 3-day-old girl presents with decreased feeding and is found to be limp and minimally responsive. After intubation, at what rate should breaths be delivered? A. 10-16 per minute B. 20-30 per minute C. 40-60 per minute D. 70-80 per minute Teaching Image  Question 2 In a malnourished patient, which of the following sources of megaloblastic anemia is expected to develop first? A. Folic acid deficiency B. Hypothyroidism C. Liver disease D. Vitamin B12 deficiency Teaching Image  Question 3 What medication should be first line treatment in moderate musculoskeletal back pain? A. Acetaminophen B. Cyclobenzaprine C. Diazepam D. Oxycodone Question 4 An 18-year-old male presents to the ED with a 4 cm laceration to the right side of his chin. Which of the following nerve blocks is most appropriate? A. A mental nerve block B. A posterior superior alveolar nerve block C. A stellate ganglion block D. An apical nerve block Teaching Image  Question 5 A previously healthy 5-year-old girl presents to the ED with left lower extremity pain and an inability to bear weight for 1 day. Mom denies any recent trauma. On exam, the patient has a T 37.9°C, HR 130, and RR 28. Her left lower extremity is slightly flexed and externally rotated. Lab evaluation reveals a WBC of 8,000, a C-reactive protein of 1 mg/dL, and an erythrocyte sedimentation rate (ESR) of 7 mm/hr. Radiographs are negative for fracture. The patient’s range of motion has improved following administration of ibuprofen. What is the most appropriate course of action in this patient? A. Intravenous antibiotics and admission to the hospital B. MRI to rule out osteomyelitis or septic arthritis C. Orthopedic consultation for arthrocentesis D.