The most difficult thing is the decision to act, the rest is merely tenacity. The fears are paper tigers. You can do anything you decide to do. You can act to change and control your life; and the procedure, the process is its own reward.   -Amelia Earhart Welcome back to Roshcast Episode 37! This week, we’re continuing our collaboration with the EM Clerkship podcast. We’ll cover 3 EKG related questions in addition to 3 randomly generated questions. Maybe we’ll even get to a trauma question… As a reminder, listen closely for the trauma ring tone during this episode and the next episode. And e-mail us at [email protected] or tweet us at roshcast the exact time of the ring tone to win a subscription. With the in training exam right around the corner this will certainly help get you ready for February 28th. Let’s get going with a rapid review from a recent post on the Rosh Review Blog. * Supracondylar fracture is the most common type of pediatric elbow fracture. Typically caused by falling on an outstretched hand — or a FOOSH.  * In a posterolaterally displaced supracondylar humeral fracture you should be concerned for the median nerve. This can be tested by asking the patient to make an “OK” sign and checking sensation at the volar tip of the index finger * For a posteromedially displaced supracondylar fracture you should be concerned about the radial nerve. Have the patient try to make a “thumbs up” sign. And check sensation along the dorsal web space of the hand.  Now onto this week’s podcast Question 1  A previously healthy patient who presents with leg pain is found to have a clot within the tibial vein. Which of the following treatments is most likely indicated? A. Aspirin for 6 months B. Heparin and warfarin C. Repeat ultrasound in 2-5 days D. Warfarin alone Question 2 Which of the following is associated with a shortened PR interval?  A. Brugada Syndrome B. Mobitz 2° AV Block C. Wellens Syndrome D. Wolff-Parkinson-White syndrome Teaching Image Question 3 A 29-year old man presents after a syncopal episode. His ECG reveals an epsilon wave, a small positive deflection buried in the end of the QRS complex. Which of the following tests will likely identify the cause of the patient’s syncope? A. Cardiac catheterization B. Cardiac MRI C. Electrophysiology study D. Stress testing Teaching Image Question 4 A 12-year-old boy is brought to the ED after being struck in the chest by a baseball during a baseball game. He collapsed immediately upon impact and has been unresponsive since. Which of the following dysrhythmias is most commonly associated with this condition? A. Asystole B. Supraventricular tachycardia C. Ventricular fibrillation D. Ventricular tachycardia Teaching Image Question 5 A 57-year-old man with hypertension presents complaining of a 6-hour history of a “floater” in the right eye. He states that he has had increasing difficulty reading as the cloudy area blocks his visual field. Additionally, he complains of decreased vision in his right eye. Which of the following represents the appropriate management? A.