The High-Yield Podcast

Approach to workup of cholangitis, chronic cholecystitis, Gallstone Ileus, Cholangiocarcinoma including Klatskin tumor, Carcinoma of GB and Pancreas At the end some house-cleaning on iatrogenic complications of gallstone disease after ERCP and other procedures are discussed (including bile duct injury and bile leak); For SOD refer to previous episode on cholecystitis management and complications of cholecystectomy.

Both Pathophysiology and Clinical Aspects of gallstone disorders are discussed followed by important hints on differential diagnosis of gallstone disease from one another and from their complications, most specifically from cholecystitis and cholangitis.

Questions & cases regarding diagnostic workup and management for PBC, PSC, Alcoholic & Non-Alcoholic Fatty Liver Disease (steatosis, steatohepatitis), and Vascular Hepatopathy

Question-based review of differential diagnosis in chronic HBV vs HCV infection.

Questions-based review of risk factors, differential diagnosis and management of acute viral hepatitis A, D , E . Included co-infection, Superinfection, diagnostic workup (screening and confirmatory) and management options with discussion of post-exposure prophylaxis for HAV infection.

Following the SOAP approach, we review Subjective, Objective, Assessment & Plan for Ascites & Peritonitis. Exudative versus Transudative classification compared to new SAAG-based classification are discussed for differential diagnosis. Values of SAAG in relation to Protein content, Cell count, LDH and Glucose and pH values as well as major risk factors are discussed to differentiate primary (spontaneous) versus 2ndary bacterial peritonitis. and management guidelines provided. Needs some mathematical understanding of SAAG formula and couple exceptions to the rules (as discussed).

Question-based review of Acute liver failure, staging of hepatic encephalopathy (per clinical & EEG criteria), management of ALF with understanding of the severity criteria, Stage-based management of hepatic encephalopathy, Indications & Eligibility requirement for Liver transplantation, and a brief discussion on acetaminophen toxicity at the end.

Case-Based Review of Respiratory Failure Management. Please make sure you understand the indications & contraindications for supplemental versus active (invasive & non-invasive) modes of ventilatory support before going through cases.

Question-based and quick review of important subject of patients in need of invasive active airway intervention (as opposed to those who benefit from non-invasive intervention or those who just need supplemental oxygenation without a need for active airway). We discuss endotracheal intubation (including crash intubation, RSI, Elective ETI) and we discuss alternatives including crycothyrotomy versus long-term surgical airway indication (i.e. Tracheostomy).

Brief but high-yield question-based approach to differential diagnosis in hypercapnic failure. Analyzing the differentials and management options based on the formula of Alveolar Minute Ventilation: Alveolar Minute Ventilation = Respiratory Rate x (Tidal Volume - Dead Space Volume) VA = RR x (Vt-Vd) DDxing of hypercapnia includes low RR (e.g. opiate use), Low Vt (e.g restrictive lung disease) or high Vd (COPD).

Differential Diagnosis of metabolic Alkalosis and the overall approach to metabolic alkalosis with cases and step-up scenarios including Saline-Responsive and Unresponsive Types based on Urine Chloride; Brief yet high-yield review of compensation and how to make sense of compensation formulas in acid-base disorders. Also discussed: Syndrome of apparent mineralocorticoid excess (SAME, Including Liddle Syndrome), Gitelman & Bartter;

Question-based discussion of the proper framework approach metabolic acidosis, serum versus urinary anion gap, categories of high-anion-gap versus normal anion-gap acidosis and are discussed.

Question-based Review on Differential Diagnosis of Hypercalcemia (Pseudohypercalcemia, PTH-dependent vs PTH-independent Hypercalcemia) and Hypocalcemia; Vitamin D abnormalities, Abnormalities of Phosphate. Also discussed: Workup & Management of Humoral Hypercalcemia of Malignancy, Familial Hypocalciuric Hypercalcemia, Pseudohypoparathyroidism, True Hypoparathyroidism, Primary, 2ndary and tertiary hyperparathyroidism, Medications Side-Effects causing abnormalities of Ca & P.