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The 2019 Lifelong Learning And Self-Assessment Study Guide - LLSA

About this review

The 2019 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 2019 LLSA reading list; a review of each article, with key points identified for efficient exam prep.

New Features

Key Points Highlighted in the Original Article Text

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

Bookmarks in the PDF

  • Quickly locate the review or article 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

Audio Summary of the Reviews

  • Synthesize the information in the study guide with an alternative learning method
  • Review the information in a concise timeframe
  • Reinforce the key points of the original articles
  • Study on-the-go

Review Modules

  • Review 1: Clinical Practice Guideline: Brief Resolved Unexplained Events (Formerly Apparent Life-Threatening Events) and Evaluation of Lower-Risk Infants: Executive Summary (Sample)
  • Review 2: Executive Leadership and Physician Well-being: Nine Organizational Strategies to Promote Engagement and Reduce Burnout
  • Review 3: Management of an Unexpected Delivery in the Emergency Department
  • Review 4: Treatments for Hyperemesis Gravidarum and Nausea and Vomiting in Pregnancy: A Systematic Review
  • Review 5: Fire-Related Inhalation Injury
  • Review 6: Managing Initial Mechanical Ventilation in the Emergency Department
  • Review 7: Mesenteric Ischemia
  • Review 8: Managing Migraine
  • Review 9: Pediatric Nontraumatic Hip Pathology
  • Review 10: Current Controversies in Thrombolytic Use in Acute Pulmonary Embolism
  • Review 11: New-Onset Seizure in Adults and Adolescents: A Review
  • Review 12: Clinical Policy: Critical Issues in the Evaluation of Adult Patients With Suspected Transient Ischemic Attack in the Emergency Department

Audio Sample

Click here to download the audio file to listen on the go (Available on Android or via Dropbox on IOS devices.)

Reviewers

Ilene Claudius, MD
Associate Professor; Director, Process & Quality Improvement Program, Harbor-UCLA Medical Center, Torrance, CA
 
Rowen O. Jin, MD
Department of Emergency Medicine, LAC+USC, Los Angeles, CA
 
Kaushal H. Shah, MD
Associate Professor and Residency Director, Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
 
Angela Chen, MD
Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
 
Suzanne Bentley, MD, MPH, FACEP
Associate Professor, Departments of Emergency Medicine and Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY; Medical Director, Simulation Center at Elmhurst Hospital Center, Elmhurst, NY
 
Jillian Nickerson, MD, MS
Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
 
Benjamin H. Schnapp, MD
Assistant Professor, BerbeeWalsh Department of Emergency Medicine, University of Wisconsin, Madison, WI
 
Daniel J. Ritter, MD
BerbeeWalsh Department of Emergency Medicine, University of Wisconsin, Madison, WI
 
Angela Hua, MD
Assistant Professor, Hofstra University; Department of Emergency Medicine, Northwell Long Island Jewish Hospital, New Hyde Park, NY
 
Luke B. Berry, MD
Department of Emergency Medicine, Northwell Long Island Jewish Hospital, New Hyde Park, NY
 
Joby Thoppil, MD, PhD
Department of Emergency Medicine, Northwell Long Island Jewish Hospital, New Hyde Park, NY
 
Mark Andreae, MD
Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
 
Rosalia Holzman, MD
BerbeeWalsh Department of Emergency Medicine, University of Wisconsin, Madison, WI
 
Taylor McCormick, MD, MS
Attending Physician, Department of Emergency Medicine, Denver Health Medical Center, Denver, CO; Assistant Professor, University of Colorado School of Medicine, Aurora, CO
 
Patrick Joynt, MD, MA
Department of Emergency Medicine, Denver Health and Hospital Authority, Denver, CO
 
Jacqueline Paulis, MD
Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
 
Leila L. PoSaw, MD, MPH, FACEP
Emergency Ultrasound Director, Jackson Memorial Hospital, Miami, FL
 
Alok Harwani, MD
BerbeeWalsh Department of Emergency Medicine, University of Wisconsin, Madison, WI

Information on the ABEM LLSA examination

  • The LLSA examination is one of the 3 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.
  • This 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 CreditsTM or 35 ACEP Category I Credits included at no extra charge with your LLSA Study Guide
  • Specialty CME credits: 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: Clinical Practice Guideline: Brief Resolved Unexplained Events (Formerly Apparent Life-Threatening Events) and Evaluation of Lower-Risk Infants: Executive Summary

  1. Article Citation
  2. Synopsis
  3. Discussion
    1. Definition of a Brief Resolved Unexplained Event
    2. Suggested Clinical Approach
      1. Risk Stratification
      2. Concerning History and Physical Examination Findings
      3. Management of Lower-Risk Patients
  4. Critique
  5. Key Points
  6. Editor’s Note
  7. Original Article

Review 2: Executive Leadership and Physician Well-being: Nine Organizational Strategies to Promote Engagement and Reduce Burnout

  1. Article Citation
  2. Synopsis
  3. Discussion
    1. Strategy 1: Acknowledge and Assess the Problem
    2. Strategy 2: Harness the Power of Leadership
    3. Strategy 3: Develop and Implement Targeted Interventions
    4. Strategy 4: Cultivate Community at Work
    5. Strategy 5: Use Rewards and Incentives Wisely
    6. Strategy 6: Align Values and Strengthen Culture
    7. Strategy 7: Promote Flexibility and Work-Life Integration
    8. Strategy 8: Provide Resources to Promote Resilience and Care
    9. Strategy 9: Facilitate and Fund Organizational Science
    10. Summary
  4. Critique
  5. Key Points
  6. Original Article

Review 3: Management of an Unexpected Delivery in the Emergency Department

  1. Article Citation
  2. Synopsis
  3. Discussion
    1. Delayed Cord Clamping
    2. Thermoregulation
    3. Elements of Neonatal Resuscitation
      1. Airway
      2. Breathing
      3. Circulation
      4. Medications and Fluids
    4. Postresuscitation Monitoring and Evaluation
      1. Thermoregulation
      2. Glucose Monitoring
      3. Laboratory Testing
      4. Medications
      5. Apgar Scoring
  4. Critique
  5. Key Points
  6. Original Article

Review 4: Treatments for Hyperemesis Gravidarum and Nausea and Vomiting in Pregnancy: A Systematic Review

  1. Article Citation
  2. Synopsis
  3. Discussion
  4. Critique
  5. Key Points
  6. Original Article

Review 5: Fire-Related Inhalation Injury

  1. Article Citation
  2. Synopsis
  3. Discussion
    1. Pathophysiology
    2. Diagnosis
    3. Clinical Course and Management
  4. Critique
  5. Editor’s Note
  6. Key Points
  7. Original Article

Review 6: Managing Initial Mechanical Ventilation in the Emergency Department

  1. Article Citation
  2. Synopsis
  3. Discussion
    1. Lung-Protective Strategy
    2. Obstructive Strategy
  4. Critique
  5. Editor’s Note
  6. Key Points
  7. Original Article

Review 7: Mesenteric Ischemia

  1. Article Citation
  2. Synopsis
  3. Discussion
    1. Etiology and Pathophysiology
      1. Acute Arterial Occlusion and Insufficiency
      2. Venous Occlusion
      3. Chronic Mesenteric Ischemia
    2. Diagnostic Approach
    3. Treatment
      1. Initial Resuscitation
      2. Anticoagulation
      3. Surgical and Endovascular Approaches
  4. Critique
  5. References
  6. Key Points
  7. Original Article

Review 8: Managing Migraine

  1. Article Citation
  2. Synopsis
  3. Discussion
    1. Diagnosis and Workup
    2. Treatment
    3. Disposition
  4. Critique
  5. Key Points
  6. Original Article

Review 9: Pediatric Nontraumatic Hip Pathology

  1. Article Citation
  2. Synopsis
  3. Discussion
    1. Pathology
    2. Suggested Clinical Approach
      1. History and Physical Examination
      2. Imaging
      3. Laboratory Investigations
    3. Differential Diagnosis
      1. Transient Synovitis
      2. Legg-Calve-Perthes Disease
      3. Slipped Capital Femoral Epiphysis
      4. Septic Arthritis and Osteomyelitis
      5. Lyme Arthritis
      6. Malignancy
  4. Critique
  5. Key Points
  6. Original Article

Review 10: Current Controversies in Thrombolytic Use in Acute Pulmonary Embolism

  1. Article Citation
  2. Synopsis
  3. Discussion
    1. Overview of Management of Pulmonary Embolism
    2. Analysis of Thrombolytic Use in Submassive Pulmonary Embolism
      1. MAPPET-3 (Management Strategies and Prognosis of Pulmonary Embolism Trial-3)
      2. MOPPET (Moderate Pulmonary Embolism Treated with Thrombolysis)
      3. PEITHO (Pulmonary Embolism Thrombolysis) Trial
      4. TOPCOAT (Treatment of Submassive Pulmonary Embolism with Tenecteplase or Placebo: Cardiopulmonary Outcomes at 3 months) Trial
      5. Additional Studies Evaluating Thrombolytic Use in Submassive Pulmonary Embolism
    3. Summary of Management of Pulmonary Embolism
  4. Critique
  5. References
  6. Editor’s Note
  7. Key Points
  8. Original Article

Review 11: New-Onset Seizure in Adults and Adolescents: A Review

  1. Article Citation
  2. Synopsis
  3. Discussion
    1. Definitions
    2. Systematic Approach to Patients With New-Onset Seizure
      1. Step 1: Did the Patient Have a Seizure?
      2. Step 2: Was This an Acute Symptomatic Seizure?
      3. Step 3: Was This an Unprovoked Seizure?
    3. Epidemiology
    4. Risk Factors
    5. Differential Diagnosis
    6. Assessment and Diagnosis
      1. History and Physical Examination
      2. Brain Imaging
      3. Chemistry Panel
      4. Prolactin Level
      5. Lumbar Puncture
    7. Risk of Seizure Recurrence
      1. Acute Symptomatic Seizures
      2. Unprovoked Seizures
    8. Treatment
      1. Step 1: Who Gets Treated?
      2. Step 2: Is the Epilepsy Focal or Generalized?
      3. Step 3: Are the Seizures Controlled?
      4. Step 4: What is the Duration of Treatment?
    9. Antiepileptic Medications
      1. Special Considerations
      2. Generic Formulations
      3. Comparative Trials
      4. Adverse Effects
      5. Antiepileptic Medication Use in Women
      6. Use in Older Patients
    10. Response Rates
    11. Patient Counseling
    12. Duration of Therapy
  4. Critique
  5. Editor’s Note
  6. Key Points
  7. Original Article

Review 12: Clinical Policy: Critical Issues in the Evaluation of Adult Patients With Suspected Transient Ischemic Attack in the Emergency Department

  1. Article Citation
  2. Synopsis
  3. Discussion
  4. Critique
  5. Editor’s Note
  6. Key Points
  7. Original Article
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