Welcome back to Episode 28! We are already well into intern year. Remember it is a roller coaster, with ups and downs, but in the end, you will really appreciate just how far you have come. This week we start off with a quick ophthalmology review and then dive into the new material, covering ob/gyn, pediatric dermatology, torsades de pointes and much more. Let’s get started. * Acute angle closure glaucoma classically presents with painful monocular vision loss. The pupil would be fixed and mid-dilated with a hazy cornea and perilimbic injection. * Optic neuritis is characterized by central vision loss with preserved peripheral vision. Patents may also have pain with eye movement and reduced color vision. * Retinal detachment is associated with painless monocular vision loss with floaters and flashing lights. The retina can appear dull and gray. Call ophthalmology immediately for any retinal detachment. Now onto this week’s podcast Question 1 A 27-year-old woman presents with vaginal bleeding. Her last menstrual period was eight weeks ago. On physical examination, there is a small amount of blood in the vaginal vault with an open internal cervical os. Bedside ultrasound reveals an intrauterine pregnancy with a fetal pole but no heartbeat. Which of the following is the most likely diagnosis? A. Incomplete miscarriage B. Inevitable miscarriage C. Missed abortion D. Threatened miscarriage Teaching Image Question 2 How does the Diagnostic and Statistical Manual (DSM-V) code personality and developmental disorders? A. Axis I B. Axis II C. Section I D. Section II Question 3 A 35-year-old woman with a known history of seizure disorder is actively seizing in the ED. Which of the following is the first-line medication and route to treat her seizure? A. Intramuscular fosphenytoin B. Intravenous midazolam C. Oral lorazepam D. Rectal diazepam Teaching Image Question 4 Which of the following statements is true regarding airway management in children? A. Adults are more susceptible to airway obstruction than children B. Children have a lower basal oxygen consumption compared to adults which results in relative protection from hypoxia and decreased need for pre-oxygenation C. The glottic opening in children is more anterior compared to that of adults D. The vocal cords are the narrowest portion of the airway in children compared to the cricoid ring in adults Teaching Image Question 5 An 11-month old male is brought in by his mother for fever, irritability, and rash. She reports that other children at his daycare have similar symptoms. You see the following on physical exam as seen above. Which of the following is true regarding this condition? A. Intravenous steroid administration is the mainstay of therapy B. It is less common in children over 6 years of age C. Nikolsky’s sign is negative D. The condition is uniformly fatal Teaching Image Question 6 A patient with palpitations presents to the ED. Her rhythm strip is seen above.