Secrets from CME4Life's PANCE/PANRE board review 

For the PA boards... I want all to think narrow (artial) complex. I understand it's not a criteria... but studying for the boards is different that study for clinical practice.

Thank you for the feedback, it was much appreciated. As a student with a tremendous for passion for EKG (and the proper interpretation thereof), I wanted to clarify the "narrow complex" criterion stated in your wonderful video so that students don't misconstrue what you were trying to convey. When using language such as wide complex or narrow complex, the reference is usually to wide or narrow QRS (ventricular) complexes, not wide or narrow atrial P-waves or fibrillatory F-waves. Remember that a complex is a summation of different waves, hence "QRS" complex. EKG is hard enough as it is, so proper vernacular is crucial for proper interpretation of electrocardiographic wave-forms. I particularly liked your segment on how to treat the subtle differences in a true V-tach arrhythmia, but I would like to add one thing which I am constantly teaching my co-workers and classmates: how important it is to discern subtle criteria within a wide QRS complex, as scrutinizing the wide QRS complex can change management. For example, SVT with aberrancy (RBBB) will always cause a telemetry alarm, and sometimes even a 12-lead EKG, to misinterpret the rhythm as "V-TACH" due to the wide complex, but that doesn't mean you go into the room and treat it like a V-Tach as per the algorithm you teach in this video! In this situation, it would be important to know how SVT with aberrant conduction looks like and treat it like any other SVT: with adenosine of course! In EKG, we diagnose based on criteria, so having an intimate knowledge of major criteria is fundamental. Having worked as a telemetry tech for 4 years, under the tutelage of many doctors, I have had the fortune of familiarizing myself with many important criteria for virtually every basic and advanced arrhythmia. Thank you for helping us PA students out under the tutelage of your videos, I'm starting PACKRAT testing soon and am using your videos to help!

Hey John, question about adenocarcinoma of the lung. You mentioned there's no hemoptysis but then said if someone's spitting up blood they're going to come in early. Can you clarify that a bit a more? Adeno is a poorer prognosis and is that because of the mets to the liver? I'll be attending your 3 day conference btw and I can't wait! As you can see I am getting a head start on my studying. =)

+Shivali Dave I love that you are on the ball.... great proactive nature. Adenocarcinoma is peripheral in the lungs - away from the big airways. So, hemoptysis is less likely. It's squamous cell and oat cell (small cell) that is central ... thus hemoptysis.

+John Bielinski makes sense - thank you for the prompt reply!

hahahaha