Podcast #313: Flu Screening

Podcast #313: Flu Screening

Author: Dr. Peter Bakes

Educational Pearls:

  • High risk patients: underlying lung disease, immunocompromised, extremes of age (<2 or >65), underlying cardiac/renal/neurologic disease, and pregnant women
  • Testing: RT-PCR (RNA based test that is both sensitive and specific)
  • Workup: comorbidities dictate whether or not they are screened; CXR indicated in high risk patients with respiratory symptoms
  • Morbidity from flu comes from secondary pneumonia, sepsis, and septic shock
  • Treatment options are Tamiflu and Relenza (Relenza is contraindicated in patients with lung disease)
  • High risk patients see average of 2.5 days shortening of illness and a decrease in illness severity. Low risk patients see average of 1.5 days shortening of illness.

References:

https://www.cdc.gov/flu/about/disease/high_risk.htm

Binnicker MJ, Espy MJ, Irish CL, Vetter EA. Direct Detection of Influenza A and B Viruses in Less Than 20 Minutes Using a Commercially Available Rapid PCR Assay. J Clin Microbiol. 2015 Jul; 53(7): 2353-4.

Longo, Dan L. (2012). "187: Influenza". Harrison's principles of internal medicine (18th ed.). New York: McGraw-Hill. ISBN 9780071748896.

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Podcast #351: Indications for AICD

Podcast #351: Indications for AICD

Author: Pete Bakes, MD Educational Pearls: AICD: Automated Implantable Cardioverter-Defibrillator. Can be placed for secondary prevention of cardiac arrest (i.e. history of cardiac arrest not fr...

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Podcast # 350: Pressors and Ischemia

Podcast # 350: Pressors and Ischemia

Author: Nick Hatch, MD. Educational Pearls: A common concern using vasopressors is the risk of digital and mesenteric ischemia. The absolute risk of digital ischemia and/or mesenteric ischemia is...

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Podcast # 349: Fat Emboli

Podcast # 349: Fat Emboli

Author: Sue Chilton, MD Educational Pearls: Triad of fat emboli syndrome is a petechial rash, AMS, and respiratory distress. Petechiae usually start in the axilla. 90% of patients with long bon...

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Podcast # 348: Steakhouse Syndrome

Podcast # 348: Steakhouse Syndrome

Author: Don Stader, MD Educational Pearls: Steakhouse syndrome is an impacted esophageal food bolus. Occurs because they have an esophageal stricture (schatzki ring, scarring, esophagitis). Cla...

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Podcast # 347: Fasting and Procedural Sedation

Podcast # 347: Fasting and Procedural Sedation

Author: Sam Killian, MD Educational Pearls: Recent study examining fasting and adverse events during procedural sedation found no association between fasting duration and any type of adverse event....

29 Juni 20183min

Podcast # 346: Pediatric DKA

Podcast # 346: Pediatric DKA

Author: Chris Holmes, MD Educational Pearls: There is a risk of cerebral edema in pediatrics with DKA if over resuscitated. Recent study comparing normal saline vs. ½ normal saline showed no diff...

27 Juni 20184min

Podcast # 345: Epidural Abscess

Podcast # 345: Epidural Abscess

Author: Sue Chilton, MD Educational Pearls: IV drug use and spinal procedures are major risk factors. Classic triad of back pain, focal neurological deficit and fever. However, presence of fever ...

25 Juni 20184min

Podcast # 344: Foley troubleshooting

Podcast # 344: Foley troubleshooting

Author: Aaron Lessen, MD. Educational Pearls: When foley is stuck, balloon may not have deflated. Make sure balloon is not in the urethra, which can block drainage. Cut off the port as it may b...

22 Juni 20183min

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