The 2020 Lifelong Learning And Self-Assessment Study Guide - LLSA

About this Review

The 2020 LLSA Study Guide includes all of the resources you need to prep for the ABEM LLSA exam: a full reprint of every article on the 2020 LLSA reading list; a review of each article, with key points identified for efficient exam prep.

 

Features of the LLSA Study Guide

Key points summarized in the review

• Find pertinent information quickly, to facilitate review of the information
• Supplement and support the key points in the review

Bookmarks in the PDF

• Quickly locate the review that you want to study
• Navigate the PDF file with one easy click
• Mark pages for your own use and come back to them later

ABEM Quick Quiz

• Utilize ABEM’s fill-in-the-blank questions at the beginning of each review to test your knowledge and improve material recall as you read the reviews
• Check the answers provided at the end of each review to aid in retention
• ABEM Quick Quiz questions emphasize key points, as determined by ABEM

Study questions

• CME questions to help you test yourself on your knowledge of the material
• Answers and explanations to the questions that drive home the main points

Article summary and critiques

• A summary of the article with critical discussion and critique of the article
• Additional information and resources not provided in the original articles that can be applied to practice
• Links to additional reading

Continuing education credits

• 35 AMA PRA Category 1 Credits^TM

Related EB Medicine issues

• Links to monthly EB Medicine issues and topics provide you with a deeper dive into practice-changing content, with more detailed information on topics covered in the study guide.

Login

Purchase

Review Modules

• Review 1: Acute Diarrheal Infections in Adults Sample
• Review 2: Acute Myocardial Infarction
• Review 3: Physical Abuse of Children
• Review 4: Acute Lower Gastrointestinal Bleeding
• Review 5: Necrotizing Soft-Tissue Infections
• Review 6: Nonpenetrating Eye Injuries in Children
• Review 7: Changes in Provider Prescribing Patterns After Implementation of an Emergency Department Prescription Opioid Policy
• Review 8: The Pediatric Airway and Rapid Sequence Intubation in Trauma
• Review 9: Emergency Department Management of Pediatric Shock
• Review 10: Idarucizumab for the Reversal of Dabigatran
• Review 11: Safety of Magnetic Resonance Imaging in Patients With Cardiac Devices
• Review 12: Acute Spinal Cord Compression
• Review 13: Thrombectomy for Stroke at 6 to 16 Hours With Selection by Perfusion Imaging

Reviewers

Suzanne Bentley, MD, MPH, FACEP

Attending Physician, Department of Emergency Medicine, NYC Health + Hospitals/ Elmhurst, Elmhurst, NY; Associate Professor, Departments of Emergency Medicine and Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY

Luke B. Berry, MD

Department of Emergency Medicine, Northwell Health Long Island Jewish Hospital, New Hyde Park, NY

Lauren Boehm, MD

Department of Pediatrics, New York University, New York, NY

Moira Carroll, MD

Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY

Martin F. Casey, MD, MPH

Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY

Evan Feinberg, MD

Department of Emergency Medicine, Northwell Health at North Shore University Hospital and Long Island Jewish Medical Center, New Hyde Park, NY

Rosalia Holzman, MD

BerbeeWalsh Department of Emergency Medicine, University of Wisconsin-Madison, Madison, WI

Gwendolyn Hooley, MD

Department of Emergency Medicine, Mount Sinai Hospital, New York, NY

Angie Hua, MD

Faculty, Department of Emergency Medicine, Northwell Long Island Jewish Hospital, New Hyde Park NY; Assistant Professor, Donald and Barbara Zucker School of Medicine at Hofstra University, New Hyde Park, NY

Joe Kebisek, MD

University of Connecticut School of Medicine, Farmington, CT

Daniel Patino-Calle, MD

Department of Emergency Medicine, University of Connecticut, Hartford, CT

Avital Porat, MD

Director of Quality and Safety, Department of Emergency Medicine, Hartford Hospital, Hartford, CT

Leila L. PoSaw, MD, MPH, FACEP

Emergency Ultrasound Director, Department of Emergency Medicine, Jackson Memorial Hospital, Miami, FL

Arjun Prabhu, MD, MBE

Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY

Daniel J. Ritter, MD

BerbeeWalsh Department of Emergency Medicine, University of Wisconsin-Madison, Madison, WI

Jennifer E. Sanders, MD

Assistant Professor and Associate Fellowship Director, Pediatric Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY

Benjamin H. Schnapp, MD, MEd

Assistant Professor and Associate Residency Program Director, BerbeeWalsh Department of Emergency Medicine, University of Wisconsin-Madison, Madison, WI

Kaushal H. Shah, MD

Vice Chair of Education, NYP-Weill Cornell Department of Emergency Medicine, New York, NY

Taryn Webb, MD

Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY

Information on the ABEM LLSA examination

• Depending on your recertification year, the LLSA examination is one of the components required for maintenance of certification (MOC) with the American Board of Emergency Medicine (ABEM).
• The primary goal of the LLSA examination is to promote continuous learning by diplomates.
• ABEM facilitates this learning by identifying an annual set of LLSA readings to guide diplomates in self-study of recent EM literature. Readings are intended to address issues relevant to current clinical practice.
• EB Medicine’s study guide is created each year for emergency medicine physicians preparing for the ABEM examination required for maintenance of their certification.

CME Information

• 35 AMA PRA Category 1 Credits^TM or 35 ACEP Category I Credits included at no extra charge with your LLSA Study Guide
• Included as part of the 35 credits, this CME activity is eligible for 3 Critical Care credits, 3 Ethics credits, 6 Neurology credits, 6 Obstetrics/Gynecology credits, 4 Pharmacology credits, and 3 Trauma credits, subject to your state and institutional requirements.

Table of Contents

Review 1: Acute Diarrheal Infections in Adults

1. Article Citation
2. Synopsis
3. Quick Quiz
4. Discussion
5. Critique
6. References
7. Key Points
8. Quick Quiz Answers
9. Original Article

Review 2: Acute Myocardial Infarction

1. Article Citation
2. Synopsis
3. Quick Quiz
4. Discussion
   1. Epidemiology
   2. Pathophysiology
   3. Initial Evaluation, Diagnostic Testing, and Risk Stratification
   4. Initial Medical Care
      1. Prehospital Care
      2. Emergency Department and Early Inpatient Care
   5. Treatment of ST-Segment Elevation Myocardial Infarction
   6. Treatment of Acute Coronary Syndromes Without ST-Segment Elevation
   7. Antithrombotic Therapy
      1. Antiplatelet Agents
      2. Anticoagulant Agents
      3. Combined Oral Anticoagulant and Antiplatelet Therapy
   8. Complications
   9. Late Inpatient and Predischarge Care
   10. Future Direction
5. Critique
6. Editor’s Note
7. Reference
8. Key Points
9. Quick Quiz Answer
10. Original Article

Review 3: Physical Abuse of Children

1. Article Citation
2. Synopsis
3. Quick Quiz
4. Discussion
   1. The Clinical Problem
   2. Strategies and Evidence
   3. Areas of Uncertainty
5. Critique
6. Key Points
7. Editor’s Note
8. Quick Quiz Answers
9. References
10. Original Article

Review 4: Acute Lower Gastrointestinal Bleeding

1. Article Citation
2. Synopsis
3. Quick Quiz
4. Discussion
   1. Clinical Presentation
   2. Initial Assessment
   3. Initial Management
   4. Diagnostic Evaluation and Therapies
   5. Antiplatelet Medications and Acute Lower Gastrointestinal Bleeding
5. Critique
6. Key Points
7. Editor’s Note
8. Quick Quiz Answers
9. Original Article

Review 5: Necrotizing Soft-Tissue Infections

1. Article Citation
2. Synopsis
3. Quick Quiz
4. Discussion
   1. Definition and Classification
   2. Classification of Necrotizing Fasciitis
      1. Necrotizing Fasciitis Type I
      2. Necrotizing Fasciitis Type II
      3. Necrotizing Fasciitis Type III
      4. Other Pathogens Causing Necrotizing Skin Infections
   3. Diagnosis of Necrotizing Skin Infections
      1. Clinical Findings
      2. Imaging
      3. Tissue Biopsy, Histologic Testing, and Gram Stain
      4. Serum Analysis
      5. Laboratory Risk Indicator for Necrotizing Fasciitis Scoring System
   4. Treatment
      1. Surgical Intervention
      2. Pharmacologic Treatment
      3. Management of Associated Critical Problems
      4. Adjunctive Treatment
5. Critique
6. Key Points
7. Editor’s Note
8. Quick Quiz Answers
9. Original Article

Review 6: Nonpenetrating Eye Injuries in Children

1. Article Citation
2. Synopsis
3. Quick Quiz
4. Discussion
   1. Corneal Abrasions
   2. Chemical Ocular Burns
   3. Traumatic Hyphema
   4. Orbital Fractures
   5. Traumatic Iritis
   6. Posterior Eye Injuries
5. Critique
6. Editor’s Note
7. Additional Reading
8. Key Points
9. Quick Quiz Answers
10. Figure
    1. Figure 1. The Seidel Test
11. Original Article

Review 7: Changes in Provider Prescribing Patterns After Implementation of an Emergency Department Prescription Opioid Policy

1. Article Citation
2. Synopsis
3. Quick Quiz
4. Discussion
   1. Guidelines and Education
   2. Outcomes and Conclusions
5. Critique
6. Key Points
7. Editor’s Note
8. Quick Quiz Answers
9. Figure
   1. Figure 1. Opioid Prescriptions Compared to Patient Visits
10. Original Article

Review 8: The Pediatric Airway and Rapid Sequence Intubation in Trauma

1. Article Citation
2. Synopsis
3. Quick Quiz
4. Discussion
   1. Pediatric Airway Anatomy
   2. Airway Adjuncts
   3. Indications for Rapid Sequence Intubation
   4. Preoxygenation
   5. Pediatric Airway Management Equipment
   6. Identifying Difficult Airways
   7. Induction Agents
   8. Paralytics
   9. Complications
   10. Specific Pediatric Trauma Considerations
5. Critique
6. Key Points
7. Editor’s Note
8. Quick Quiz Answers

Review 9: Emergency Department Management of Pediatric Shock

1. Article Citation
2. Synopsis
3. Quick Quiz
4. Discussion
   1. Recognition and Management of Shock in the Pediatric Population
      1. Fluid Resuscitation, Vasoactive Medications, Steroids, Antibiotics, and Intubation
      2. Assessing Resuscitation
5. Critique
6. Key Points
7. Editor’s Note
8. Quick Quiz Answers
9. Table
   1. Table 1. Signs and Symptoms of Hemorrhage by Class
10. Original Article

Review 10: Idarucizumab for the Reversal of Dabigatran

1. Article Citation
2. Synopsis
3. Quick Quiz
4. Discussion
   1. Glund, Moschetti, Norris, et al (Thrombosis and Haemostasis, 2015)
   2. Glund, Stangier, Schmohl, et al (Lancet, 2015)
   3. Glund, Stangier, van Ryn, et al (Clinical Pharmacokinetics, 2017)
   4. Glund, Stangier, van Ryn, et al (Journal of the American College of Cardiology, 2016)
   5. Pollack, Reilly, Eikelboom, et al (The New England Journal of Medicine, 2015)
   6. Limitations of the Studies
5. Critique
6. Editor’s Note
7. Key Points
8. Additional Reading
9. Quick Quiz Answers
10. Original Article

Review 11: Safety of Magnetic Resonance Imaging in Patients With Cardiac Devices

1. Article Citation
2. Synopsis
3. Quick Quiz
4. Discussion
5. Critique
6. Key Points
7. Quick Quiz Answers
8. Original Article

Review 12: Acute Spinal Cord Compression

1. Article Citation
2. Synopsis
3. Quick Quiz
4. Discussion
   1. Overview and General Features of Acute Spinal Cord Compression
   2. Traumatic Spinal Cord Compression
   3. Neoplastic Epidural Spinal Cord Compression
   4. Spinal Epidural Abscess
5. Critique
6. Editor’s Note
7. Additional Reading
8. Key Points
9. Quick Quiz Answers
10. Original Article

Review 13: Thrombectomy for Stroke at 6 to 16 Hours With Selection by Perfusion Imaging

1. Article Citation
2. Synopsis
3. Quick Quiz
4. Discussion
5. Critique
6. Editor’s Note
7. Additional Reading
8. Key Points
9. Quick Quiz Answers
10. Figure
    1. Figure 1. DEFUSE 3 Trial Outcomes
11. Original Article