Summary: <br> <br> The secret of change is to focus all of your energy, not on fighting the old, but on building the new. <br><br> -Socrates<br> <br> Welcome back to RoshCast for Episode 42! With the in-training exam around the corner, go back and power through old episodes during commutes to pick up as many points as possible. Good luck!<br> <br> <br> * Patent ductus arteriosus (or PDA) closes, the neonate will present in heart failure and shock.<br> * Turner’s Syndrome is associated with Coarctation. Turner’s is also associated with webbed neck, short stature, and low-set ears.<br> * Individuals with Turner’s syndrome are missing an X chromosome as well, making it a 45 XO chromosomal condition.<br> * A blood pressure differential between the arms and legs — specifically, the pressure in the arms is higher than the legs. Depending on the specific anatomy, you might even note a difference in the pressures between both arms.<br> * Classic EKG and chest x-ray findings associated with coarctation of the aorta include left ventricular hypertrophy and rib notching, respectively.<br> <br> Now onto this week’s podcast<br> <br> <br> Question 1 <br> Which of the following is typically seen in Korsakoff syndrome?<br> A. Cerebellar dysfunction<br> B. Long-term memory impairment<br> C. Ophthalmoplegia<br> D. Recent memory impairment<br> <a href="https://www.roshreview.com/wp-content/uploads/Ep42-Wernicke-Korsakoff.png" rel="lightbox[2248]">Teaching Image</a> <br> Question 2<br> Which of the following is the most common physical exam finding in an abdominal aortic aneurysm?<br> A. Abdominal bruit<br> B. Diminished femoral pulses<br> C. Duodenal obstruction<br> D. Pulsatile abdominal mass<br> <a href="https://www.roshreview.com/wp-content/uploads/Ep42-AAA.jpg" rel="lightbox[2248]">Teaching Image</a><br> Question 3<br> A 24-year-old woman at full term presents with rupture of membranes and contractions. Sterile exam reveals a crowning infant with a visible cord. After elevating the fetal head, what management is indicated? <br> A. Clamp and cut cord and proceed with delivery<br> B. Continue with standard delivery<br> C. Emergent cesarean section <br> D. Intravenous tocolytics<br> <a href="https://www.roshreview.com/wp-content/uploads/Ep42-Umbilical-Cord-Prolapse.jpg" rel="lightbox[2248]">Teaching Image </a><br> Question 4<br> You suspect a 35-year-old man has epiglottitis with impending airway compromise. Which of the following is the best method for confirming the diagnosis?<br> A. Computed tomography of the neck<br> B. Frontal cervical soft tissue radiograph <br> C. Indirect laryngoscopy<br> D. Lateral cervical soft tissue radiograph<br> <a href="https://www.roshreview.com/wp-content/uploads/Ep41-Epiglottitis.png" rel="lightbox[2248]">Teaching Image</a><br> Question 5<br> A 21-year-old man presents with a stab wound to the right chest. His vitals are HR 157, BP 81/43, RR 28, and oxygen saturation 91%. The patient is intubated and packed red blood cells are started. Physical examination reveals a bleeding wound to the right chest, a midline trachea and decreased breath sounds on auscultation of the right hemithorax. Which of the following should be performed next?<br> A. Application of a pelvic binder<br> B. Placement of a right thoracostomy tube<br> C. Right chest thoracotomy<br> D. Transfer to operating room<br> <a href="https://www.roshreview.com/wp-content/uploads/Ep42-Traumatic-Hemothorax.png" rel="lightbox[2248]">Teaching Image </a><br> Question 6<br> <br> A 65-year-old man with a history of hypertension presents with left sided weakness beginning two hours prior to arrival. Vitals are BP 155/85 mm Hg, HR 102, RR 12, oxygen saturation 100% on RA. His CT scan is shown above. Which of the following therapies is appropriate?<br> A. Antihypertensives to lower mean arterial pressure by 25%<br> B.
