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Emergency Medicine Emergency Medicine curriculum =============================== Conquer Emergency Medicine Boards with Confidence Core Advanced Emergency Medicine Core Pathway ### Basic Sciences 2,168 questions #### Anatomy for anesthesia (airway, neuraxial, vascular, regional) 50 - Neuraxial anatomy and dermatomes - Dermatome and block height assessment 4 - Meninges and CSF spaces 4 - Vertebral column and ligamentous structures 4 - Peripheral nerve anatomy (regional anesthesia essentials) - Brachial plexus overview 5 - Lower limb plexuses 5 - Truncal blocks anatomy 5 - Upper airway anatomy and airway assessment landmarks - Airway examination correlates 5 - Nasal and oral cavity anatomy 4 - Pharynx and larynx anatomy 5 - Vascular access anatomy - Arterial access anatomy 4 - Central venous anatomy 5 #### Anatomy, Surgical Anatomy & Pelvic Support 70 Gross and applied anatomy relevant to obstetrics, gynecology, pelvic surgery, continence/prolapse, a... - Adnexa and tubo-ovarian anatomy - Broad ligament spaces and adnexal torsion anatomy 2 - Fallopian tube segments and function 3 - Ovary—blood supply and surgical implications 2 - Parametrium and ureteric course 2 - Pelvic sidewall landmarks 3 - Bony pelvis, pelvic diameters, and obstetric biomechanics - Anatomy relevant to operative vaginal birth 3 - Maternal pelvis shapes and relevance 3 - Mechanisms of labor and fetal head molding 3 - Pelvic floor interaction with birth 3 - Pelvimetry concepts and clinical utility 2 - Breast anatomy and lactation-relevant structures - Breast ducts, lobules, and lymphatics 3 - Breast imaging anatomy correlation 2 - Nipple–areolar complex anatomy 3 - Physiology-anatomy interface in lactation 3 - Surgical anatomy (duct excision, abscess drainage) basics 3 - Pelvic floor, continence mechanisms and anorectal anatomy - Anal sphincter complex 4 - Levator ani and fascial supports 3 - Lower urinary tract anatomy 2 - Neurovascular anatomy relevant to pelvic pain 3 - Perineum and episiotomy landmarks 3 - Uterus, cervix, vagina and vulva—applied anatomy - Cervical anatomy and transformation zone 2 - Lymphatic drainage of lower genital tract 3 - Uterine layers and supporting ligaments 3 - Vaginal anatomy and fornices 3 - Vulvar anatomy 4 #### Applied Anatomy for Emergency Care 117 Regional anatomy relevant to resuscitation, procedures, and time-critical diagnosis. - Abdominal and pelvic anatomy for acute abdomen - Appendix, bowel, mesentery 5 - Genitourinary anatomy 5 - Hepatobiliary and pancreatic anatomy 5 - Pelvic anatomy and hemorrhage 3 - Peritoneal spaces and referred pain 5 - Airway, neck, and upper aerodigestive anatomy - Airway edema/obstruction implications 5 - Larynx and trachea 4 - Neck vascular/nerve structures 4 - Surgical airway anatomy (foundational) 4 - Upper airway landmarks 5 - Musculoskeletal compartments and vascular anatomy - Compartment syndrome anatomy 4 - Fracture patterns and growth plates (intro) 5 - Major joints: stability and reduction basics 5 - Ultrasound-relevant vascular anatomy 5 - Vascular anatomy for hemorrhage control 5 - Neuroanatomy and spinal anatomy for EM - Cerebral vascular territories (exam-relevant) 5 - Intracranial compartments and herniation 4 - Ocular and orbital anatomy 5 - Peripheral nerve anatomy for injuries/blocks 5 - Spinal cord/nerve root anatomy 5 - Thoracic anatomy and pleura - Chest wall, ribs, diaphragm 5 - Mediastinum and great vessels 6 - Pericardium and cardiac anatomy basics 5 - Pleural spaces and lung lobes 5 - Procedural anatomy (thoracic) 3 #### Biochemistry, Metabolism & Nutrition 37 Core metabolic pathways, organ metabolism, and clinically important deficiencies/excesses. - Carbohydrate and lipid metabolism (clinically applied) - Glycolysis/gluconeogenesis concepts 3 - Inborn errors (overview) 4 - Lipid metabolism 3 - Obesity and insulin resistance 2 - Micronutrients and deficiency syndromes - Fat-soluble vitamins 3 - Refeeding syndrome 3 - Trace elements 3 - Water-soluble vitamins 3 - Protein metabolism and liver synthetic function - Albumin and oncotic pressure 4 - Amino acid metabolism 4 - Bilirubin metabolism 3 - Coagulation factors synthesis 2 #### Cardiovascular physiology and measurement 71 - Cardiac electrophysiology and ECG basics - Arrhythmia mechanisms (exam core) 5 - Cardiac action potentials 4 - Conduction system anatomy/physiology 5 - Defibrillation/cardioversion principles 5 - ECG interpretation for anesthesia 5 - Cardiac pump function and determinants of CO - Autonomic control of circulation 5 - Determinants of SVR and MAP 4 - Frank–Starling physiology 5 - Myocardial oxygen supply/demand 5 - Pressure–volume concepts 6 - Shock physiology (core principles) 5 - Oxygen transport and hemodynamic oxygenation metrics - Hemoglobin–oxygen dissociation curve 4 - Microcirculation basics 5 - Oxygen consumption and extraction 4 - Oxygen content and delivery 4 #### Cellular & Molecular Biology 43 Core cellular structure/function and signaling relevant to disease mechanisms and therapeutics. - Cell structure, organelles, and trafficking - Cell cycle, apoptosis, necrosis 3 - Cell–cell junctions and extracellular matrix 4 - Membrane structure & transport 4 - Organelles and key functions 4 - Oncogenesis fundamentals - Cancer immunology (intro) 3 - Carcinogenesis & exposures 3 - Hallmarks of cancer (board-level) 3 - Tumor suppressors and oncogenes 4 - Signal transduction & second messengers - Inflammation signaling 4 - Pharmacologic implications 3 - Receptor classes 4 - Second messengers 4 #### Clinical epidemiology, biostatistics, and evidence-based practice 55 Board-relevant study design, diagnostic testing performance, screening, clinical decision-making, an... - Basic statistics interpretation (board level) - Confidence intervals 3 - Hypothesis testing and p-values 3 - Inter-rater reliability and kappa 2 - Measures of central tendency and spread 3 - Regression basics (conceptual) 3 - Diagnostic test characteristics - Decision rules (e.g., PECARN concept) 3 - Interpreting lab reference ranges in pediatrics 3 - Likelihood ratios and post-test probability 2 - ROC curves and thresholds (conceptual) 2 - Sensitivity, specificity, predictive values 3 - Screening principles and prevention evidence - Clinical practice guidelines (CPGs) 3 - Criteria for screening programs 4 - Ethics in evidence application 3 - Number needed to treat/harm 3 - Public health measures and outbreak basics 2 - Study designs and hierarchy of evidence - Diagnostic test studies 3 - Interventional studies (RCTs) 3 - Observational studies (cohort, case-control, cross-sectional) 2 - Quality improvement vs research (distinction) 3 - Systematic reviews and meta-analyses 2 #### Clinical pharmacology and therapeutics (core) 76 Weight-based dosing, pediatric pharmacokinetics/dynamics, antimicrobial fundamentals, common drug cl... - Analgesia, sedation, and peri-procedural medications - Common agents and adverse effects 4 - Local anesthetics and toxicity 4 - Non-opioid analgesics 3 - Opioids and respiratory depression risk 3 - Procedural sedation core concepts 4 - Antimicrobial classes and selection (foundational) - Aminoglycosides and nephro/ototoxicity 2 - Antiviral/antifungal overview (core) 3 - Beta-lactams and cephalosporins 4 - Macrolides and atypical coverage 3 - MRSA agents (clindamycin, TMP-SMX, vancomycin, linezolid) 2 - Common pediatric chronic medication classes (core board level) - Antiepileptic drugs overview 3 - Asthma/allergy pharmacotherapy basics 4 - Cardiac medications basics 3 - Endocrine medications basics 3 - Psychotropic basics (overview) 3 - Pediatric dosing principles and medication safety - Adverse drug reaction types 3 - Medication reconciliation and error prevention 3 - Routes of administration and bioavailability 3 - Therapeutic drug monitoring (TDM) basics 3 - Weight-based dosing and dose limits 2 - Pediatric pharmacokinetics and pharmacodynamics - Absorption differences by age 3 - Distribution (body water/fat, protein binding) 3 - Elimination (renal maturation) 3 - Metabolism (hepatic enzymes) 2 - Pharmacogenomics basics (board overview) 3 #### Core anesthesia pharmacology (drug classes) 95 - Cardiovascular drugs commonly used in anesthesia - Antiarrhythmics (core familiarity) 4 - Antihypertensives and antianginals 5 - Vasopressors and inotropes 6 - Inhalational anesthetics - MAC and factors affecting MAC 6 - Organ effects and toxicity 6 - Special phenomena 5 - Uptake and distribution 4 - Intravenous induction agents and sedatives - Benzodiazepines 4 - Dexmedetomidine and alpha-2 agonists 4 - Etomidate 4 - Ketamine 5 - Propofol 5 - Neuromuscular blockers and reversal agents - Depolarizing blockade (succinylcholine) 4 - Monitoring and reversal 4 - NMJ physiology relevant to blockade 5 - Nondepolarizing blockade 4 - Opioids and adjunct analgesics - Adjuvant analgesics (exam-relevant) 4 - Common IV opioids in anesthesia 5 - Non-opioid analgesics (core) 5 - Opioid receptor pharmacology 6 #### Core Physiology and Pathophysiology 147 High-yield physiologic principles that underpin ED presentation patterns and first-line therapy. - Acid–base physiology and interpretation - Metabolic acidosis 4 - Metabolic alkalosis 5 - Osmolar gap and toxin clues 4 - Respiratory acidosis/alkalosis 5 - Systematic interpretation approach 5 - Inflammation, immunity, and sepsis pathobiology - Anaphylaxis physiology 5 - Coagulation-inflammation interface 5 - Fever physiology 4 - Host response to infection 6 - Vaccines, immunization status, and ED relevance 5 - Neurophysiology of consciousness, seizure, and delirium - Delirium and encephalopathy mechanisms 3 - Raised ICP physiology 4 - Reticular activating system and coma basics 6 - Seizure generation and termination (conceptual) 4 - Temperature and CNS function 5 - Oxygen delivery, shock physiology, and perfusion - Determinants of oxygen delivery 4 - Fluid responsiveness and endpoints 5 - Reperfusion and resuscitation complications 5 - Shock classification and physiology 6 - Vasopressors/inotropes physiology 6 - Renal physiology and electrolyte homeostasis - Acute kidney injury pathophysiology 6 - Calcium, magnesium, phosphate physiology 6 - Diuretics and renal pharmacodynamics (intro) 5 - Potassium physiology and membrane excitability 6 - Sodium and water balance 5 - Respiratory mechanics and gas exchange - Acid-base interplay in respiratory disease 4 - Hypoxemia mechanisms 5 - Ventilation strategy principles (intro) 5 - Ventilation vs oxygenation concepts 5 - Work of breathing and fatigue 4 #### Developmental physiology and anatomy 103 Age-dependent structure and function across fetal, neonatal, infant, child, and adolescent stages re... - GI, hepatic, and pancreatic developmental physiology - Bilirubin metabolism 2 - Feeding physiology and gastric emptying 4 - Gut microbiome concepts (board-relevant) 3 - Liver synthetic function and vitamin K 3 - Pancreatic function maturation 2 - Neurodevelopmental physiology (foundation) - Brain development timing and vulnerability 3 - Intracranial pressure basics 3 - Pain pathways and developmental differences 3 - Seizure physiology overview 3 - Sleep physiology across development 3 - Fetal-to-neonatal transition physiology - Cardiovascular transition and shunts 3 - Neonatal glucose homeostasis 3 - Placental to pulmonary gas exchange transition 3 - Respiratory adaptation 3 - Thermoregulation at birth 3 - Hematopoiesis and pediatric hemostasis basics - Age-based CBC norms 3 - Coagulation and bleeding evaluation foundations 3 - Hemoglobin switching and oxygen affinity 3 - Iron metabolism and erythropoiesis 3 - Transfusion medicine basics 4 - Pediatric cardiovascular physiology basics - Blood pressure norms and perfusion 3 - Cardiac output determinants by age 2 - Congenital heart physiology patterns 3 - Oxygen delivery and consumption 2 - Shock physiology overview 3 - Pediatric respiratory mechanics basics - Age-dependent airway anatomy 3 - Basic blood gas interpretation 4 - Pulmonary defense mechanisms 3 - Ventilation-perfusion relationships 3 - Work of breathing and fatigue 2 - Renal maturation and fluid homeostasis - Acid handling and bicarbonate physiology 3 - Neonatal electrolyte vulnerabilities 3 - Neonatal renal function and GFR maturation 3 - Urine output norms and interpretation 3 - Water balance regulation 3 #### Embryology, Fetal Development & Congenital Anomalies 42 Embryology and developmental physiology underpinning congenital anomalies and reproductive tract dis... - Gametogenesis, fertilization, implantation and early placentation - Amniotic fluid development and regulation 3 - Fertilization and early embryo development 2 - Implantation physiology and abnormal implantation 3 - Oogenesis and spermatogenesis essentials 3 - Placental development and cord formation 3 - Müllerian development and reproductive tract anomalies - Cervical insufficiency developmental considerations 2 - Congenital anomalies—screening principles 3 - Müllerian duct fusion and canalization 3 - Ovarian and testicular differentiation 3 - Urogenital sinus development 2 - Organogenesis and teratology timing - Common teratogens and patterns 5 - Congenital infection pathogenesis (TORCH concept) 3 - Critical periods of development 2 - Fetal growth regulation 2 - Placental transfer and fetal drug exposure 3 #### Emergency Pharmacology and Therapeutics 117 PK/PD and emergency drug classes frequently tested and used in ED resuscitation and symptom control. - Analgesia in emergency medicine - Ketamine for analgesia 3 - Non-opioid analgesics 5 - Opioid pharmacology and safe prescribing 6 - Pain syndromes and multimodal strategy 4 - Regional anesthesia principles (intro) 5 - Antimicrobials and stewardship essentials - Allergy, anaphylaxis, and cross-reactivity 5 - Antibiotic adverse effects 5 - Antiviral/antifungal (board-level) 5 - Empiric antibiotic selection principles 4 - High-yield ED syndromes (empiric) 4 - Cardiovascular and vasoactive medications - Antiarrhythmics and rate control 5 - Antihypertensives in emergencies 5 - Antithrombotics and reperfusion adjuncts 6 - Reversal agents (core overview) 5 - Vasopressors/inotropes 5 - Pharmacokinetics/pharmacodynamics in the ED - Absorption, distribution, metabolism, elimination 4 - Drug interactions and adverse drug events 5 - Medication safety principles 5 - Onset/offset and context-sensitive half-time 5 - Pharmacogenomics and variability (board-level) 3 - Sedation, induction agents, and anxiolysis - Benzodiazepines 5 - Dexmedetomidine (board-level overview) 4 - Ketamine dissociation 4 - Procedural sedation safety 5 - Propofol and etomidate basics 5 #### Epidemiology, Biostatistics & Evidence-Based Medicine 45 Study design, bias, test performance, causality, and applying evidence to patient care. - Clinical guidelines and evidence synthesis - Ethics in research 3 - GRADE and strength of recommendation 3 - Implementation and de-implementation 3 - Systematic reviews/meta-analyses 3 - Diagnostic test interpretation - Bayesian reasoning 2 - Core measures 3 - ROC curves and thresholds 2 - Screening principles 3 - Study design and validity - Bias and confounding 3 - Causality and inference 3 - Interventional trials 3 - Observational designs 4 - Treatment effects and risk - Decision analysis basics 3 - Effect size measures 2 - Heterogeneity and subgroup analyses 3 - Time-to-event analysis 2 #### Fluids, electrolytes, and acid–base 83 Core calculations and physiologic reasoning for pediatric fluid management, electrolyte abnormalitie... - Calcium, magnesium, and phosphate disorders - Hypercalcemia differential and initial workup 2 - Hypomagnesemia and refractory hypokalemia/hypocalcemia 2 - Neonatal hypocalcemia (early/late) 3 - Phosphate abnormalities (refeeding, DKA) 3 - QT prolongation and electrolyte-related arrhythmias 3 - Acid–base disorders and interpretation - Bicarbonate therapy: indications and risks 4 - Metabolic acidosis differential (high vs normal anion gap) 4 - Metabolic alkalosis differential 3 - Respiratory acidosis/alkalosis scenarios 3 - Stepwise blood gas interpretation 3 - Hypernatremia in children - Central diabetes insipidus management 3 - Correction strategy and monitoring 3 - Etiologies and diagnostic approach 3 - Nephrogenic diabetes insipidus basics 2 - Neurologic complications of dysnatremias 2 - Hyponatremia in children - Acute symptomatic hyponatremia management 3 - Classification by volume status 3 - Osmotic demyelination risk 2 - Pseudohyponatremia and lab pitfalls 3 - SIADH approach 3 - Maintenance fluids and dehydration management - Assessment of dehydration severity 3 - Hypernatremic dehydration 2 - IV fluid bolus and deficit replacement 3 - Maintenance fluid calculation and composition 3 - Oral rehydration therapy (ORT) 2 - Potassium disorders (hypo/hyperkalemia) - Hyperkalemia emergency management 3 - Hyperkalemia recognition and ECG changes 3 - Hypokalemia causes and evaluation 2 - Renal tubular disorders related to potassium 3 - Replacement strategies and safety 2 #### Genetics & Genomics 31 Mendelian and complex genetics, genomic medicine, and clinically actionable variants. - Complex traits and gene–environment interaction - Epigenetics 3 - Microbiome (board-level concepts) 2 - Polygenic risk concepts 3 - Somatic mosaicism & clonal hematopoiesis 2 - Genomic testing in clinical practice - Ethical issues 2 - Pharmacogenomics 3 - Testing modalities 2 - Variant interpretation 3 - Mendelian inheritance and risk - Autosomal dominant patterns 3 - Autosomal recessive patterns 3 - Mitochondrial inheritance 2 - X-linked inheritance 3 #### Genetics and metabolism (introductory) 57 Foundations of inheritance, genetic testing, dysmorphology approach, and introductory inborn error r... - Dysmorphology and congenital anomaly approach - Approach to a dysmorphic child 3 - Common genetic syndromes (core list) 3 - Referral and multidisciplinary care 2 - Syndromic vs sequence vs association concepts 3 - Teratology basics 4 - Inborn errors: pattern recognition (intro) - Hypoglycemia patterns and ketones 3 - Lactic acidosis and mitochondrial disease overview 2 - Metabolic acidosis and hyperammonemia patterns 3 - Newborn with lethargy/vomiting after feeds 3 - Recurrent rhabdomyolysis and exercise intolerance 2 - Genetic testing modalities and indications - Ethical considerations in pediatric genetics 2 - Karyotype, microarray, and targeted panels 3 - Newborn screening follow-up basics 3 - Prenatal testing concepts (board-level) 2 - Single-gene sequencing and exome/genome sequencing 3 - Patterns of inheritance and pedigree interpretation - Autosomal dominant/recessive patterns 3 - Chromosomal abnormalities overview 4 - De novo variants and recurrence risk 3 - Multifactorial inheritance and risk 3 - X-linked and mitochondrial inheritance 3 #### Genetics, Immunology, Hematology & Teratology 65 Genetic principles, prenatal screening/diagnosis frameworks, immunohematology (Rh), and teratology r... - Genetic inheritance and counseling fundamentals - Carrier screening concepts 4 - Chromosomal abnormalities and mechanisms 4 - Consanguinity and risk quantification basics 2 - Genetic test ethics and informed consent 3 - Patterns of inheritance 4 - Immunohematology and alloimmunization - Fetal anemia assessment principles 2 - Non-D antibodies and clinical relevance 3 - RhD immunization prevention 3 - Thrombophilia concepts 3 - Transfusion medicine basics in OB 4 - Prenatal screening and diagnostic testing - Aneuploidy screening modalities 3 - Diagnostic procedures principles 3 - Neural tube defect screening and diagnosis 4 - Non-immune hydrops framework 3 - Screening test performance interpretation 3 - Teratology and environmental exposures - Infections as teratogens (TORCH) 4 - Medication risk frameworks 3 - Occupational/environmental hazards 4 - Radiation exposure in pregnancy 3 - Substance use and fetal effects 3 #### Hematology, Transfusion, and Evidence-Based Medicine 94 Coagulation, transfusion science, and biostatistics/EBM essentials commonly assessed in EM training... - EBM in practice: guidelines, pathways, and stewardship - Antimicrobial and imaging stewardship 4 - Applying guidelines safely 3 - Critical incident literature appraisal (M&M style) 4 - Quality metrics vs patient-centered outcomes 4 - Screening and prevention in ED context 5 - Biostatistics and clinical epidemiology for EM - Bias, confounding, and validity 4 - Clinical prediction rules and implementation 6 - Diagnostic test performance 5 - Measures of effect and uncertainty 4 - Study designs and hierarchy of evidence 5 - Hemostasis and coagulation fundamentals - Bleeding risk stratification (conceptual) 4 - Coagulopathies in the ED 6 - Heparin/DOAC physiology and lab interpretation 5 - Primary vs secondary hemostasis 6 - Thrombosis physiology 5 - Transfusion medicine and massive hemorrhage basics - Blood products and indications 5 - Hemolysis and anemia emergencies 5 - Massive transfusion principles 5 - Rh/alloimmunization principles (ED-relevant) 4 - Transfusion reactions 5 #### Immunology & Inflammation 36 Innate/adaptive immunity, hypersensitivity, autoimmunity, immunodeficiency, and transplant fundament... - Adaptive immunity - B cell biology and antibodies 4 - Hypersensitivity reactions 3 - T cell biology 3 - Vaccinology principles 2 - Autoimmunity and tolerance - Central and peripheral tolerance 3 - Immunodeficiency overview 3 - Systemic autoimmune disease mechanisms 3 - Transplant immunology (intro) 3 - Innate immunity and inflammation - Complement system 3 - Inflammation resolution 3 - Pattern recognition and cytokines 3 - Phagocytes and granulomatous inflammation 3 #### Immunology, inflammation, and allergy foundations 84 Fundamental immune mechanisms, hypersensitivity, primary immunodeficiency red flags, and vaccine imm... - Autoimmunity and immune dysregulation fundamentals - Autoantibodies and immune tolerance concepts 3 - Autoinflammatory syndromes (intro) 4 - Cytokine storm/HLH conceptual bridge 3 - Cytopenias and autoimmune disease links 3 - Immune-mediated kidney and skin disease examples 3 - Hypersensitivity and allergic disease mechanisms - Atopic disease spectrum 4 - Drug allergy vs intolerance 3 - Food allergy mechanisms and tolerance 4 - Type I (IgE-mediated) reactions 4 - Type II/III/IV hypersensitivity examples 4 - Innate and adaptive immune system basics - Adaptive immunity components 4 - Complement system basics 3 - Inflammation resolution and chronic inflammation 3 - Innate immunity components 4 - Mucosal immunity and IgA 3 - Primary immunodeficiency (PID) overview and red flags - Basic lab evaluation of immune function 3 - Clinical warning signs and patterns 3 - Immunization considerations in immunocompromise 3 - Secondary immunodeficiency causes 3 - T-cell vs B-cell vs phagocyte vs complement defects 4 - Vaccine immunology foundations - Active vs passive immunity principles 3 - Adjuvants and immunogenicity 3 - Herd immunity and population impact (exam framing) 4 - Live attenuated vs inactivated vaccines 3 - Vaccine adverse events and safety systems 3 #### Maternal–Fetal Physiology, Placenta & Parturition 55 Pregnancy adaptations, uteroplacental unit physiology, and labor physiology essential for safe obste... - Maternal cardiovascular and hemodynamic adaptations - Blood pressure physiology across trimesters 3 - Changes in blood volume, CO, SVR 3 - Coagulation physiology (hypercoagulability) 2 - Postpartum hemodynamic shifts 3 - Uterine blood flow physiology 2 - Placental function, transport, and endocrine activity - Amniotic fluid dynamics 3 - Maternal–fetal immunology 2 - Placental endocrine hormones 3 - Placental transport mechanisms 3 - Umbilical and fetal circulation physiology 3 - Respiratory, renal, and acid–base physiology in pregnancy - GI/hepatic adaptations 3 - Hematologic adaptations beyond coagulation 3 - Renal changes and lab interpretation 3 - Thermoregulation and skin changes 3 - Ventilatory changes and ABG interpretation 2 - Uterine contractility and cervical remodeling - Cervical ripening mechanisms 3 - Lactation physiology 3 - Myometrial excitation–contraction coupling 2 - Postpartum uterine involution 2 - Stages of labor physiology 4 #### Neurophysiology, autonomics, and thermoregulation 43 - Autonomic nervous system and reflexes - Autonomic failure and dysautonomia 6 - Key perioperative reflexes 5 - Sympathetic vs parasympathetic physiology 5 - Cerebral blood flow and intracranial dynamics - CBF regulation 5 - CSF production and drainage 4 - ICP physiology 4 - Thermoregulation and perioperative hypothermia - Anesthesia effects on temperature 5 - Complications of hypothermia 4 - Normal thermoregulatory control 5 #### Nutrition, growth biology, and metabolic fundamentals 76 Core pediatric nutrition and metabolism including breastfeeding, micronutrients, malnutrition, obesi... - Energy metabolism and common IEM overview (intro) - Acute metabolic decompensation first steps 2 - Basic pathways (glycogen, FAO, urea cycle) 4 - Hypoglycemia differential by age 3 - Newborn screen concept and limitations 2 - When to refer for metabolic/genetic evaluation 3 - Failure to thrive (FTT) and malnutrition - Definitions and anthropometric assessment 3 - Differential diagnosis framework 3 - Initial evaluation and targeted testing 3 - Multidisciplinary management and safeguarding interface 3 - Nutritional rehabilitation 3 - Infant feeding (breastfeeding and formula) - Breast milk composition and benefits (exam framing) 2 - Complementary feeding and allergen introduction 4 - Feeding difficulties and red flags 3 - Formula types and indications 4 - Lactation management basics 3 - Micronutrients and deficiency states - Iodine and thyroid development 3 - Iron deficiency and anemia prevention 2 - Vitamin A, E, K deficiencies (board-relevant) 4 - Vitamin D and calcium 4 - Zinc and trace elements 3 - Pediatric obesity and metabolic risk - BMI classification and staging 4 - Lifestyle intervention fundamentals 2 - Metabolic syndrome and NAFLD overview 3 - Obesity pharmacotherapy and bariatric basics (board overview) 3 - Weight stigma and counseling skills 3 #### Pathology & General Pathophysiology 35 General injury, repair, vascular pathology, thrombosis, and systemic responses to illness. - Cell injury and adaptation - Amyloidosis (overview) 3 - Edema and effusions pathophysiology 3 - Inflammation and repair 3 - Reversible vs irreversible injury 3 - Fever, SIRS, and sepsis biology - Biomarkers (concepts) 3 - Cytokine-mediated shock 3 - Organ dysfunction mechanisms 3 - Stress response and endocrine changes 3 - Hemostasis and thrombosis (mechanisms) - Atherosclerosis & aneurysm pathophysiology 3 - Coagulation cascade (clinical interpretation) 3 - Platelet biology 2 - Thrombosis and embolism 3 #### Pathology, Neoplasia, and Breast Pathology Foundations 73 Core gynecologic and obstetric pathology and tumor biology underpinning screening, diagnosis, and in... - Inflammation, infection, and tissue response basics - Acute vs chronic inflammation patterns 2 - Necrosis patterns relevant to OB-GYN 3 - Pathology specimen handling basics 3 - Thrombosis and embolism concepts 3 - Wound healing and scar formation 3 - Breast pathology foundations for OB-GYN - Benign breast disease 3 - Breast cancer basics for generalists 3 - Breast screening and pathology correlation 4 - High-risk lesions overview 3 - Lactation-related breast conditions 3 - Cervical pathology and HPV-mediated disease - CIN/HSIL/LSIL pathologic correlates 3 - Cytology and histology interpretation basics 3 - HPV biology and carcinogenesis 3 - Invasive cervical cancer—histology overview 3 - Vaginal/vulvar intraepithelial lesions basics 3 - Endometrial pathology and AUB foundations - Benign uterine pathology 3 - Endometrial carcinoma basics (Type 1 vs Type 2) 3 - Endometrial hyperplasia classification concepts 2 - Gestational endometrium and retained products concepts 3 - Uterine sarcomas overview 3 - Ovarian, tubal, and peritoneal tumors—foundations - Borderline tumors concepts 2 - Fallopian tube origin hypothesis for HGSC 3 - GTD pathology overview 3 - Ovarian tumor classification overview 3 - Tumor markers basics 3 #### Pharmacology fundamentals (PK/PD and drug handling) 61 - Pharmacodynamics and receptor theory - Dose–response relationships 4 - Drug interactions 5 - Pharmacogenomics (core testables) 5 - Receptor types and signaling 5 - Pharmacokinetics core concepts - Bioavailability and first-pass metabolism 5 - Compartment models and parameters 6 - Organ failure effects on PK 5 - Redistribution and tissue uptake 4 - Special populations 5 - Toxicology and adverse drug reactions - Dose-related vs idiosyncratic reactions 4 - Local anesthetic systemic toxicity (principles) 5 - Methemoglobinemia and CO toxicity (periop) 4 - Opioid toxicity and reversal 4 #### Pharmacology, Microbiology & Diagnostic Science (Core) 83 High-yield medication classes, antimicrobial principles, vaccination and infection concepts, plus di... - Diagnostic test interpretation and screening science - Bias and confounding in diagnostic studies 3 - Critical values and escalation thresholds 3 - Reference ranges and pregnancy-adjusted labs 3 - Screening program principles 3 - Test characteristics and Bayes theorem intuition 3 - Gynecologic pharmacology and contraception hormones - Antibiotics/antifungals commonly used in GYN 4 - Combined hormonal contraception (CHC) pharmacology 3 - Emergency contraception 2 - Menopause therapies 3 - Progestin-only methods 4 - Medication safety in pregnancy and lactation - Medication safety in breastfeeding 3 - Peripartum anesthesia/analgesia pharmacology basics 4 - Pharmacovigilance and counseling resources 4 - Principles of prescribing in pregnancy 3 - Teratogenic medication classes (core list) 4 - Microbiology, immunology and infection prevention - Immunization principles for OB-GYN 3 - Postoperative and postpartum infections 5 - Pregnancy infections 3 - STI microbiology essentials 3 - Vaginal microbiome and common vaginitis 4 - Obstetric medication classes - Diabetes medications in pregnancy 3 - Hypertension medications in pregnancy 3 - Thromboprophylaxis and anticoagulants 3 - Tocolytics and preterm birth meds 4 - Uterotonics and postpartum hemorrhage meds 3 #### Physics, measurement, mathematics, statistics (foundations) 56 - Radiation, MRI, and ultrasound physics (foundations) - Ionizing radiation basics 3 - MRI environment hazards 4 - Ultrasound fundamentals 4 - Electrical safety and basic electronics - Electrical hazards in OR 5 - Ohm’s law and power 5 - Flow, pressure, and resistance - Laminar vs turbulent flow 5 - Poiseuille and Bernoulli principles 5 - Gas laws and vapors relevant to anesthesia - Core gas laws 5 - Humidity and airway gas conditioning 5 - Vaporization concepts 5 - Mathematics, dosing, and basic statistics - Data interpretation basics 5 - Unit conversions and drug calculations 5 #### Physiology & Homeostasis 50 System physiology emphasizing integration and mechanisms behind common clinical syndromes. - Cardiovascular physiology - ECG electrophysiology basics 4 - Exercise physiology 3 - Hemodynamics and cardiac output 3 - Vascular biology 3 - Endocrine physiology - Calcium and bone metabolism 4 - Glucose homeostasis 4 - Hypothalamic–pituitary axes 3 - Thyroid hormone action 3 - Renal physiology & volume regulation - Acid–base renal handling 3 - Glomerular filtration and hemodynamics 3 - Tubular handling of electrolytes 3 - Water balance 3 - Respiratory physiology - Acid–base and respiratory compensation 3 - Hypoxic pulmonary vasoconstriction 2 - Lung mechanics 3 - Ventilation/perfusion and gas exchange 3 #### Reproductive Endocrinology & Menstrual Cycle Physiology 45 Hormonal regulation across lifespan: puberty, cycle, pregnancy, lactation, menopause; core board phy... - Hypothalamic–pituitary–ovarian (HPO) axis regulation - Endometrial cycle and histology 3 - FSH/LH actions and ovarian steroidogenesis 3 - GnRH pulsatility and feedback loops 4 - Ovulation physiology and luteal phase 3 - Puberty physiology and normal variants 3 - Menopause and perimenopause physiology - Cardiometabolic changes around menopause 3 - Hormone therapy physiologic rationale and risks 4 - Ovarian aging and follicular depletion 3 - Premature ovarian insufficiency (POI) physiology 2 - Urogenital atrophy (GSM) pathophysiology 3 - Pregnancy endocrine physiology - Calcium/vitamin D and bone metabolism 3 - hCG, corpus luteum rescue, and placental takeover 2 - Insulin resistance and metabolic adaptations 3 - Postpartum endocrine changes 3 - Thyroid physiology in pregnancy 3 #### Respiratory physiology and acid–base 73 - Acid–base and electrolytes (physiology foundations) - Anion gap and lactate interpretation 4 - Henderson–Hasselbalch and bicarbonate buffering 5 - Key electrolytes for anesthesia 5 - Stewart/strong ion approach (conceptual) 5 - Control of breathing and perioperative respiratory depression - Central and peripheral chemoreceptors 5 - Neuromuscular weakness and ventilation 4 - Ventilatory responses to anesthesia and opioids 4 - Gas exchange: diffusion, V/Q, shunt - Alveolar gas equation and A–a gradient 5 - CO2 transport and elimination 5 - Hypoxic pulmonary vasoconstriction (HPV) 4 - V/Q mismatch vs shunt vs diffusion limitation 5 - Lung volumes, compliance, resistance, and work of breathing - Airway resistance and flow 4 - Closing capacity and FRC 4 - PFT patterns for anesthesia 5 - Static and dynamic compliance 6 - Ventilation distribution and time constants 3 ### Diagnostic Evaluation 212 questions #### Clinical Reasoning and Diagnostic Strategy 48 Differential generation, test selection, and minimizing diagnostic error. - Problem representation and differential diagnosis - Avoiding premature closure 5 - Documentation of uncertainty 4 - Illness scripts and pivot points 4 - Syndromic patterns 6 - Time course and trajectory 5 - Test characteristics and Bayesian application - False positives/negatives and spectrum bias 5 - Likelihood ratios and post-test probability 5 - Pretest probability estimation 5 - Sensitivity/specificity vs predictive values 4 - Serial testing strategies 5 #### ECG and Cardiac Diagnostic Essentials 99 ECG interpretation and bedside cardiac risk evaluation. - Decision Rules and Diagnostic Pathways - Abdominal pain and appendicitis tools (awareness) 5 - Chest pain risk tools (conceptual) 5 - Disposition decision support 5 - Head injury and C-spine rules 6 - PE assessment pathways 5 - ECG approach for emergency physicians - Common pitfalls 5 - Electrolyte and drug effects 5 - Ischemia and infarction patterns 5 - Life-threatening conduction abnormalities 5 - Rate/rhythm/axis and intervals 5 - Imaging Strategy and Interpretation (ED-focused) - Chest radiograph interpretation basics 5 - CT abdomen/pelvis decision-making 5 - CT angiography use cases 5 - Head CT indications and limitations 4 - MRI access and ED indications 5 - Point-of-Care Ultrasound (POCUS) Fundamentals - Abdominal/vascular POCUS (intro) 5 - Cardiac POCUS (intro) 5 - Core POCUS principles and artifacts 5 - eFAST and trauma applications 4 - Lung POCUS (intro) 5 #### Laboratory and Bedside Testing 65 Ordering and interpreting common ED labs and bedside tests with pitfalls. - Cardiac biomarkers and chest pain labs - BNP/NT-proBNP use pitfalls 3 - Co-oximetry and special assays (awareness) 4 - D-dimer: when not to order 4 - Point-of-care glucose and ketones 4 - Troponin interpretation strategy 5 - Core ED labs interpretation - ABG/VBG and lactate 5 - BMP/CMP patterns 5 - CBC patterns 5 - Coagulation studies 5 - Urinalysis and pregnancy testing 5 - Microbiology and infectious testing - CSF studies (intro) 4 - Cultures and timing 4 - Inflammatory markers pitfalls 4 - Respiratory viral testing and implications 4 - STI testing basics 4 ### Emergency Care Foundations 297 questions #### ED Workflow, Safety, and Core Task Domains 119 Core physician tasks: consultation, disposition, documentation, teamwork, and patient safety across... - Consultation, escalation, and interdepartmental coordination - Consultant follow-up and contingency plans 4 - Managing disagreement and delays 5 - Structured communication (SBAR/I-PASS) 5 - Transfer and accepting facility coordination 3 - When to consult 5 - Diagnostic ordering and resource stewardship - Follow-up of pending results 4 - Pretest probability thinking 5 - Radiation/contrast risk communication 4 - Stepwise testing strategies 5 - Time-critical testing 7 - Disposition planning and transitions of care - Against-medical-advice (AMA) processes 5 - Discharge readiness assessment 5 - Handover within ED and to inpatient teams 6 - Observation vs admission vs discharge 4 - Return precautions and safety-netting 5 - Documentation and medicolegal defensibility (foundational) - Communication documentation 6 - Medical decision-making documentation 5 - Privacy basics (ED-relevant) 4 - Procedure documentation essentials 5 - Results management 5 - Human factors, teamwork, and crisis resource management (CRM) basics - Closed-loop communication 4 - Debriefing fundamentals 5 - Error types and mitigation 5 - Handover safety in a busy ED 4 - Team roles and leadership behaviors 4 #### Initial Assessment and Triage 67 Approach to undifferentiated presentations, acuity stratification, and immediate stabilization prior... - ED triage and acuity stratification - Crowding-aware risk management 4 - High-risk symptoms requiring immediate evaluation 5 - Re-triage and dynamic acuity 3 - Triage categories and time-critical flags 5 - Vital signs interpretation and pitfalls 4 - Primary survey (ABCDE) and early stabilization - Airway assessment and immediate maneuvers 6 - Breathing assessment 6 - Circulation assessment 4 - Disability/neurologic quick checks 5 - Exposure/environment control 3 - Secondary survey and focused evaluation - Clinical monitoring and escalation 4 - Focused history frameworks 4 - Focused physical exam techniques 4 - Pain assessment and reassessment 5 - Red flags and risk modifiers 5 #### Symptom-Based Approaches (Foundational) 111 Structured initial differentials and first-pass workup for common undifferentiated complaints. - Fever and suspected infection approach - Antipyretics and symptomatic care 3 - Pitfalls 4 - Sepsis recognition and early actions 5 - Source identification strategy 4 - Special populations considerations 5 - Syncope and near-syncope initial approach - High-risk etiologies 5 - History/exam essentials 5 - Pitfalls 4 - Risk stratification and disposition 4 - Testing strategy 4 - Undifferentiated abdominal pain approach - Analgesia, antiemetics, and reassessment 3 - Disposition and return precautions 5 - History and location-based differentials 5 - Imaging and lab strategy (conceptual) 5 - Surgical abdomen red flags 5 - Undifferentiated chest pain approach - Initial testing and prioritization 5 - Must-not-miss diagnoses 5 - Non-cardiac etiologies overview 4 - Pitfalls and cognitive errors 5 - Risk stratification and disposition concepts 5 - Undifferentiated dyspnea approach - Bedside assessment integration 4 - Disposition decisions 4 - Initial testing and treatment bundles 5 - Life threats and immediate stabilization 5 - Pitfalls 3 ### Organ System Emergencies 874 questions #### Allergy, Dermatology, Rheumatology, and Immune-Mediated Emergencies 105 Common allergic reactions, severe skin disease, and inflammatory joint/autoimmune presentations. - Rheumatologic emergencies and back pain red flags - Acute gout/pseudogout management 5 - Autoimmune flares (SLE/vasculitis) overview 5 - Cauda equina/spinal epidural abscess awareness 4 - Disposition and safety net 4 - Temporal arteritis awareness 4 - Severe cutaneous adverse reactions (SCAR) - Consultation and disposition 4 - Differential diagnosis 5 - Initial management 4 - Pitfalls 4 - SJS/TEN recognition 4 - Anaphylaxis and severe allergic reactions - Adjuncts and limitations 4 - Diagnosis and grading 5 - Observation and discharge planning 4 - Pitfalls 4 - Treatment 4 - Angioedema (histaminergic vs bradykinin) - Airway management strategy 4 - Clinical differentiation 5 - Disposition 3 - Medication therapy 5 - Pitfalls 3 - Septic arthritis and hot swollen joint - Differential diagnosis 6 - Disposition 3 - Empiric antibiotics and consultation 4 - Special populations 5 - Workup strategy 3 #### Behavioral Health, Addiction, ENT/Ophthalmology 114 Psychiatric emergencies, intoxication/withdrawal syndromes, and common ENT/eye emergencies. - ENT emergencies (core) - Dental emergencies 6 - Epistaxis management 4 - Foreign body in nose/ear 4 - Otitis externa/media and mastoiditis awareness 6 - Peritonsillar abscess and deep neck infection awareness 5 - Agitation, psychosis, and behavioral emergencies - Chemical sedation strategies (core) 6 - De-escalation and environment 4 - Disposition 4 - Medical causes of agitation 6 - Restraints and monitoring 4 - Ophthalmologic emergencies (core) - Acute vision loss 4 - Corneal abrasion/foreign body 5 - Disposition and ophthalmology consultation triggers 4 - Eye exam essentials 4 - Red eye differential (dangerous causes) 5 - Substance intoxication and withdrawal (core) - Alcohol withdrawal 4 - Disposition and counseling 4 - Opioid intoxication and overdose 4 - Sedative-hypnotic overdose/withdrawal 4 - Stimulant intoxication 5 - Suicidal ideation and self-harm risk assessment - Capacity and involuntary hold concepts 4 - Disposition and safety planning 5 - Immediate safety and medical stabilization 4 - Pitfalls 4 - Risk assessment components 5 #### Cardiovascular Emergencies 114 Time-critical cardiac and vascular syndromes and symptom-based evaluation. - Acute coronary syndrome (ACS) and ischemic chest pain - Biomarkers and serial strategy 5 - Clinical presentations and atypical ACS 3 - Disposition and reperfusion pathways 6 - ECG-based diagnosis and pitfalls 5 - Initial ED management 5 - Acute heart failure and cardiomyopathy syndromes - Bedside assessment and imaging 4 - Cardiogenic shock recognition 4 - Differential diagnosis of dyspnea 5 - Disposition considerations 4 - Treatment pathways 3 - Dysrhythmias and palpitations - Approach to tachyarrhythmia 5 - Atrial fibrillation/flutter 4 - Bradyarrhythmias 6 - SVT 5 - Ventricular arrhythmias 5 - Hypertensive crisis and vascular catastrophes - Acute limb ischemia 4 - Aneurysm rupture recognition 4 - Aortic syndromes 4 - BP reduction principles by syndrome 4 - Hypertensive emergency syndromes 4 - Syncope and presyncope - Cardiac syncope red flags 7 - Neurogenic and reflex syncope 3 - Orthostatic and volume-related syncope 5 - Pitfalls 5 - Testing and disposition 5 #### Endocrine and Metabolic Emergencies 65 Diabetes emergencies, thyroid/adrenal crises, and metabolic derangements. - Thyroid and adrenal emergencies - Adrenal crisis 4 - Disposition 3 - Myxedema coma 4 - Pituitary apoplexy (awareness) 3 - Thyroid storm 5 - Electrolyte disorders as primary ED problem - Acid-base disorders presentation patterns 4 - Calcium/magnesium disorders 5 - Disposition and monitoring 5 - Hyponatremia/hypernatremia management principles 3 - Potassium disorders 5 - Hypoglycemia and severe hyperglycemia - Counseling and follow-up 4 - Diabetes devices and complications (awareness) 5 - DKA/HHS overview (see resuscitation) 5 - Hyperglycemia without DKA 5 - Hypoglycemia recognition and treatment 5 #### Gastrointestinal, Hepatobiliary, and Surgical Emergencies 108 Abdominal pain syndromes, GI bleeding, hepatobiliary and pancreatitis, and bowel emergencies. - Acute abdominal pain and peritonitis - Analgesia and antiemetics 5 - Common surgical diagnoses (overview) 6 - Disposition and consultation triggers 4 - Surgical abdomen recognition 5 - Workup strategy 3 - Bowel obstruction and ischemia - Disposition and time-critical pitfalls 5 - Ischemic colitis (overview) 4 - Large bowel obstruction and volvulus (awareness) 5 - Mesenteric ischemia 3 - Small bowel obstruction (SBO) 4 - Gastrointestinal bleeding - Pharmacotherapy 4 - Pitfalls 4 - Resuscitation priorities 4 - Risk stratification and disposition 5 - Upper vs lower GI bleed differentiation 3 - Hepatobiliary and pancreatic emergencies - Acute liver failure and hepatic encephalopathy (overview) 5 - Acute pancreatitis 4 - Biliary colic vs cholecystitis 4 - Cholangitis 3 - Disposition and complications 5 - Nausea, vomiting, diarrhea, and dehydration - Cannabinoid hyperemesis and cyclic vomiting (awareness) 4 - Dangerous causes to exclude 4 - Disposition 5 - Infectious gastroenteritis and foodborne illness 5 - Rehydration strategies 5 #### Hematologic/Oncologic and Infectious Syndromes 65 High-yield ED hematology, oncology emergencies, and key infectious syndromes. - Oncologic emergencies - Cancer-associated thrombosis and PE risk 3 - Hyperviscosity syndrome awareness 4 - Neutropenic fever 4 - Spinal cord compression and cauda equina (overlap) 4 - Tumor lysis syndrome (TLS) awareness 4 - Anemia, thrombocytopenia, and bleeding disorders - Coagulopathy and anticoagulant complications 5 - Sickle cell disease emergencies 4 - Symptomatic anemia management 5 - Thrombocytopenia approach 5 - Thrombotic microangiopathy awareness 3 - Sepsis syndromes and source-specific emergencies - CNS infection 4 - Endocarditis awareness 5 - Pneumonia/UTI/abdominal sepsis 6 - Skin/soft tissue sepsis and necrotizing infection 4 - Special infectious threats (board-level) 5 #### Neurologic Emergencies 114 Stroke, headache, seizure, and other time-critical neurologic presentations. - Vertigo, dizziness, and ataxia - Benign peripheral syndromes 5 - Central vs peripheral differentiation 5 - Disposition 5 - Imaging decisions 5 - Symptomatic treatment 3 - Acute ischemic stroke and TIA - Initial ED workup 4 - Pitfalls 4 - Recognition and last-known-well 6 - Reperfusion therapy pathways (conceptual) 5 - TIA risk and disposition 4 - Headache emergencies - Dangerous secondary headache red flags 5 - Disposition and follow-up 4 - Meningitis/encephalitis suspicion 4 - Primary headache management 4 - Subarachnoid hemorrhage evaluation strategy 4 - Intracranial hemorrhage and traumatic brain injury (medical overlap) - Disposition 4 - ICH/SAH presentations 7 - ICP/herniation management (intro) 4 - Imaging and consultation 6 - Immediate management 5 - Seizures and status epilepticus - Alcohol withdrawal seizures 4 - Disposition 4 - Eclampsia seizure awareness 4 - First seizure evaluation 5 - Status epilepticus algorithm (core) 4 #### Renal, Urologic, and Reproductive-Urologic Emergencies 83 Renal colic, infection, retention/obstruction, and acute scrotal pathology. - Acute scrotum and testicular emergencies - Disposition 5 - Epididymitis treatment basics 4 - Initial management 3 - Testicular torsion recognition 5 - Ultrasound and differential 5 - Renal colic and ureteral obstruction - Analgesia and antiemetics 5 - Diagnosis and imaging strategy 3 - Disposition 5 - Infected obstructed system recognition 3 - Medical expulsive therapy (awareness) 3 - Urinary retention and obstructive uropathy - Bladder decompression 3 - Complications 5 - Disposition 4 - Recognition and causes 4 - When to image/consult 5 - Urinary tract infection and pyelonephritis - Antibiotic selection principles 4 - Catheter-associated infections 4 - Cystitis vs pyelonephritis 4 - Disposition 5 - Sepsis and complications 4 #### Respiratory Emergencies 106 Common and life-threatening pulmonary presentations including obstructive, infectious, and vascular... - Upper airway infections and obstruction (ENT overlap) - Angioedema/anaphylaxis airway issues 4 - Croup/epiglottitis patterns (awareness across ages) 5 - Disposition 4 - Foreign body aspiration 2 - Smoke inhalation and airway edema 4 - Asthma and COPD exacerbations - Disposition and relapse prevention 5 - ED treatment escalation 4 - Pitfalls 4 - Severity assessment and failure markers 4 - Ventilation considerations (conceptual) 5 - Pneumonia, pleural disease, and respiratory infections - Antibiotics and supportive care 4 - CAP and atypical pneumonia presentations 6 - Diagnostics and severity assessment 4 - Disposition 4 - Pleural effusion/empyema recognition 4 - Pneumothorax and acute pleural emergencies - Complications and recurrence counseling 4 - Diagnosis methods 4 - Disposition 4 - Management options 5 - Recognition 4 - Pulmonary embolism and pulmonary vascular emergencies - Anticoagulation and reperfusion (conceptual) 5 - Disposition and follow-up 4 - Imaging choices 4 - Massive/submassive PE recognition 4 - Risk assessment and pretest probability 5 ### Procedural Skills 380 questions #### Airway and Ventilation Procedures (Core) 92 Basic airway management skills expected of EM trainees. - Surgical airway (recognition and readiness) - Anatomy and landmarks 4 - Complications 4 - Post-airway care 5 - Technique overview (board-level) 4 - When to perform 6 - Bag-valve-mask ventilation (BVM) - Airway adjuncts 3 - Complications and prevention 3 - Indications and preparation 5 - Technique and optimization 4 - Troubleshooting 5 - Endotracheal intubation (fundamentals) - Basic RSI sequence (conceptual) 6 - Common complications management 5 - Confirmation and securing 3 - Equipment and setup 5 - Indications and planning 7 - Supraglottic airway placement - Complications 4 - Contraindications/limitations 6 - Indications and device selection 4 - Insertion technique 5 - Ventilation strategy and leak management 4 #### Orthopedic and Diagnostic Procedures (Core) 111 Splinting, reductions, LP, and other foundational ED procedures. - Lumbar puncture (LP) - Complications 5 - Contraindications and pre-imaging decisions 5 - CSF interpretation basics 4 - Indications 5 - Technique basics 4 - Thoracic procedures (intro) - Analgesia and sedation considerations 4 - Chest tube thoracostomy (basic awareness) 4 - Needle decompression (recognition and basics) 4 - Post-procedure imaging and monitoring 4 - Thoracentesis (basic awareness) 3 - Joint reductions (foundational) - Ankle and patellar dislocations (awareness) 4 - Complications 4 - Finger dislocation reduction 4 - Hip dislocation (recognition and urgency) 3 - Shoulder dislocation reduction 5 - Procedural sedation (core practice) - Airway rescue and adverse events 4 - Medication choices (core) 5 - Monitoring and staffing 5 - Patient selection and risk assessment 5 - Recovery and discharge criteria 6 - Splinting and immobilization - Common splints 6 - Discharge instructions 5 - Indications and principles 4 - Neurovascular checks 4 - Splint complications 5 #### Vascular Access and Infusion Procedures 87 IV/IO access and foundational central/arterial concepts for emergency care. - Arterial puncture/line (awareness) - Common sites and collateral flow 5 - Complications 3 - Documentation 5 - Indications 4 - Technique basics (conceptual) 5 - Central venous access (foundational) - Complications 5 - Indications 4 - Post-procedure confirmation 4 - Sites and anatomic considerations 4 - Ultrasound guidance principles (intro) 4 - Intraosseous (IO) access - Analgesia for awake IO 3 - Common insertion sites 4 - Complications 5 - Indications and contraindications 4 - Technique and confirmation 4 - Peripheral IV access and troubleshooting - Aseptic technique and infection prevention 5 - Complications 4 - Difficult IV strategies 5 - IV medication administration safety 5 - Site selection and catheter choice 5 #### Wound, Skin, and Soft Tissue Procedures 90 Local anesthesia, wound repair, and abscess management. - Foreign body removal (soft tissue) - Aftercare 5 - Complications 4 - Indications and imaging 4 - Special locations 4 - Technique principles 4 - Abscess incision and drainage (I&D) - Complications 5 - Culture and antibiotics decisions 4 - Differentiating cellulitis vs abscess 5 - Disposition and follow-up 4 - Technique 4 - Laceration evaluation and repair - Aftercare 5 - Closure techniques 5 - Irrigation and debridement 4 - Special wounds 6 - Wound assessment 5 - Local and regional anesthesia (core) - Digital block and end-artery considerations 4 - Field block and infiltration technique 5 - LAST recognition and initial management 4 - Local anesthetic agents and dosing 5 - Procedural documentation and consent 4 ### Professional Practice 276 questions #### Communication, Teamwork, and Patient-Centered Care 26 Core communication behaviors, empathy under pressure, and effective teamwork. - Patient-centered communication in the ED - Agenda setting and expectation management 3 - Communicating uncertainty and risk 3 - Cross-cultural communication 3 - Delivering difficult news (foundational) 2 - Managing challenging interactions 3 - Teamwork and leadership basics - Closed-loop communication 2 - Conflict management basics 2 - Debriefing and reflective practice (intro) 2 - Handover and transitions 3 - Situational awareness and workload management 3 #### Ethics, Consent, and Legal Interfaces 39 Foundational professional obligations, capacity, consent, and ED medicolegal responsibilities. - Consent and decision-making capacity - Capacity assessment framework 2 - Informed consent in the ED 3 - Refusal of care and AMA discharge 2 - Resuscitation status and goals-of-care basics 3 - Surrogate decision-makers and minors 4 - Documentation Standards and Risk Management - Avoiding biased/stigmatizing language 2 - Handover documentation 3 - Medical decision making (MDM) clarity 3 - Procedure documentation 2 - Results follow-up and callbacks 3 - Mandatory reporting and safeguarding duties - Child abuse reporting 2 - Death certification and coroner/ME interface (awareness) 2 - Fitness to drive/duty to warn (contextual awareness) 2 - Reportable infectious diseases (awareness) 2 - Sexual assault and IPV documentation 4 #### Ethics, law, and professional responsibilities 90 Consent/assent, confidentiality, decision-making standards, safeguarding/reporting obligations, and... - Research literacy and statistics for clinicians - Critical appraisal of medical literature 3 - Data safety and privacy (overview) 3 - Ethics in research and publication 3 - Interpreting common statistical outputs 4 - Practice improvement through audit (overview) 3 - Child protection duties and reporting (core professional practice) - Communication with caregivers in suspected abuse 2 - Mandatory reporting principles 3 - Medical mimics and avoiding diagnostic error 4 - Professional boundaries and self-care after difficult cases 3 - Recognizing possible abuse and neglect (overview) 3 - Communication skills and professionalism - Conflict resolution and teamwork 3 - Cultural humility and cross-cultural communication 3 - Delivering difficult news and serious illness communication 3 - Documentation and medicolegal quality 3 - Professionalism lapses and remediation awareness 3 - Confidentiality and privacy in adolescent care - Creating confidential time in visits 3 - Electronic communication professionalism 3 - Information sharing with schools and agencies 2 - Mandatory disclosure exceptions 2 - Sensitive services (sexual health, mental health, substance use) 2 - Consent, assent, and capacity in pediatrics - Mature minor and emancipated minor concepts (jurisdiction-dependent) 3 - Parental permission vs child assent 4 - Refusal of treatment and best interest standard 3 - Research consent in minors (overview) 3 - Shared decision-making and informed consent elements 4 - Quality, safety, and clinical governance - Error disclosure and apology 3 - Infection prevention and antimicrobial stewardship (professional practice) 3 - Medication and diagnostic safety in pediatrics 3 - Patient safety fundamentals 3 - Quality improvement (QI) methods 3 #### Ethics, Law, Consent & Safeguarding 75 Professional standards for consent, confidentiality, capacity, boundaries, documentation, reporting,... - Confidentiality, privacy, and mandated reporting concepts - Adolescent confidentiality (principles) 2 - Confidentiality principles in sexual and reproductive care 3 - Human trafficking awareness 3 - Mandatory reporting (conceptual, jurisdiction-dependent) 3 - Safeguarding: IPV and sexual violence 3 - Evidence-Based Practice, Research Literacy & Guideline Use - Applying guidelines to individuals 3 - Clinical ethics in evidence translation 2 - Critical appraisal of clinical studies 3 - Research integrity and publication ethics 3 - Statistics commonly tested 3 - Informed consent and refusal of care - Consent for learners and sensitive exams 4 - Consent in emergencies 2 - Elements of informed consent 4 - Procedural consent specifics 4 - Refusal of recommended treatment 4 - Patient Safety, Quality Improvement, and Risk Management - Clinical governance and incident reporting 3 - Medicolegal risk reduction 3 - Obstetric safety bundles (conceptual) 2 - Quality improvement methods 3 - Safety culture and error science 3 - Professionalism, Teamwork, Education & Wellbeing - Clinician wellbeing and burnout prevention 3 - Equity, diversity, and respectful care 4 - Interprofessional teamwork and communication 3 - Professional boundaries and social media 2 - Teaching and supervision (clinical educator basics) 3 #### Quality, Safety, and Systems (Foundational) 46 Basics of patient safety, quality improvement, infection control, and ED operations awareness. - ED operations and flow (intro) - Consultation pathways and transfer 3 - Discharge processes and health system navigation 3 - Equity and access in ED care 3 - Handoffs and staffing considerations 3 - Throughput basics 4 - Professionalism, wellness, and boundaries - Ethical prescribing and controlled substances 3 - Fatigue, burnout, and error risk 3 - Professional boundaries and social media awareness 2 - Professional conduct and accountability 4 - Teaching and supervision basics 3 - Patient safety fundamentals - Diagnostic error mitigation 3 - High-risk medications and dosing safety 2 - Incident reporting and learning systems 3 - Infection prevention and PPE 3 - Violence prevention and workplace safety 4 ### Resuscitation And Stabilization 388 questions #### Airway and Breathing Emergencies 110 Recognition and immediate management of respiratory failure and airway threats. - Acute asthma and COPD exacerbation stabilization - Adjuncts and escalation 4 - Disposition and relapse prevention 5 - Initial ED therapy 5 - Severity assessment 4 - Ventilation strategy (intro) 6 - Oxygenation and ventilation fundamentals in resuscitation - Monitoring in respiratory distress 4 - Oxygen delivery escalation 5 - Peri-intubation risk reduction (foundational) 4 - Rapid reassessment and troubleshooting 5 - Ventilation support escalation 4 - Pulmonary edema and acute heart failure stabilization - Adjunct testing while stabilizing 4 - Disposition and monitoring 4 - Immediate management 4 - Recognition and differential 5 - Ventilatory failure escalation 5 - Upper airway obstruction and anaphylaxis/angioedema stabilization - Adjunct medications and limitations 4 - Airway planning and backup 4 - Early recognition of impending obstruction 5 - Immediate treatment 4 - Observation and biphasic risk 4 - Ventilatory failure and post-intubation stabilization (core) - Initial ventilator settings (intro) 4 - Ongoing reassessment 5 - Post-intubation confirmation and troubleshooting 4 - Post-intubation hypotension management 3 - Sedation/analgesia after intubation 5 #### Circulatory Collapse and Shock 117 Cardiac arrest, peri-arrest dysrhythmias, and shock state stabilization. - Hypertensive emergencies (stabilization) - BP reduction principles 5 - Common IV agents (conceptual) 4 - Hypertensive urgency and outpatient follow-up 4 - Recognizing end-organ injury 5 - Secondary causes awareness 4 - Bradycardia and tachycardia with instability - Atrial fibrillation/flutter with RVR 5 - Bradycardia management 4 - Narrow-complex tachycardia management 5 - Recognition of unstable features 5 - Wide-complex tachycardia management 4 - Cardiac arrest (BLS/ACLS principles) - Airway and ventilation during arrest 4 - Defibrillation and rhythm management 5 - High-quality CPR 4 - Post-ROSC care (initial) 4 - Reversible causes (Hs & Ts) approach 7 - Sepsis recognition and early ED management - Antibiotics and fluids 5 - Disposition and escalation 5 - Sepsis screening and severity assessment 5 - Source identification and initial diagnostics 5 - Vasoactive support initiation 4 - Shock states: rapid classification and initial management - Cardiogenic shock 5 - Hypovolemic/hemorrhagic shock 5 - Obstructive shock 5 - Septic shock initial bundle 4 - Undifferentiated shock approach 5 #### Neurologic and Metabolic Emergencies 118 Rapid stabilization of altered mental status, seizures, endocrine crises, and temperature-related in... - Altered mental status (AMS): immediate stabilization - Agitation safety and de-escalation 5 - Dangerous causes framework 6 - Diagnostics while stabilizing 5 - Disposition and reassessment 4 - Immediate reversible checks 5 - DKA/HHS and severe dysglycemia stabilization - Bicarbonate and phosphate (selective) 4 - Disposition and complication monitoring 5 - Fluid resuscitation principles 4 - Insulin therapy and potassium management 4 - Recognition and initial labs 4 - Electrolyte emergencies causing instability - Hyperkalemia stabilization 6 - Hypernatremia and dehydration 6 - Hypocalcemia/hypercalcemia emergencies 4 - Hypomagnesemia and torsades 5 - Hyponatremia with neurologic symptoms 4 - Status epilepticus and seizure emergencies - Febrile seizures and pediatric considerations 4 - Initial stabilization and first-line therapy 4 - Postictal management and evaluation 5 - Second-line antiseizure therapy (core awareness) 4 - Seizure differential and triggers 5 - Temperature emergencies stabilization - Drowning and immersion injury (initial) 5 - Frostbite and cold injury (initial) 5 - Heat stroke and severe hyperthermia 5 - Hypothermia and cardiac instability 5 - Malignant hyperthermia/NMS/serotonin syndrome awareness 5 #### Trauma Resuscitation (Core) 43 Time-critical trauma stabilization principles and immediate hemorrhage control. - Massive hemorrhage and transfusion in trauma (core) - Balanced resuscitation principles 4 - Coagulopathy, hypothermia, acidosis triad 5 - Disposition and definitive care coordination 4 - Recognition of hemorrhagic shock 5 - TXA and hemostatic adjuncts (awareness) 3 - Primary survey and trauma team leadership (ATLS principles) - Airway with C-spine protection 5 - Breathing and chest injury recognition 5 - Circulation and hemorrhage control 5 - Disability and rapid neuro assessment 3 - Exposure and hypothermia prevention 4 ### Special Populations 396 questions #### Advanced Special Population Integration 14 Category placeholder to maintain structure; see 'Special Populations (Advanced)' domain set above. - Integrated advanced special populations review - Critically ill neonate/child 3 - Geriatric frailty and anticoagulation complications 3 - High-risk pregnancy emergencies 3 - Immunocompromised/oncology emergencies 3 - Palliative and end-of-life care 2 #### Cultural, linguistic, and refugee mental health 17 Culturally safe care, interpreter use, trauma and displacement, and diagnostic adaptations. - Refugee trauma and complex needs - Care coordination with social/legal supports 5 - Pre-, peri-, post-migration stressors 4 - Cultural formulation and culturally bound expressions - Eliciting explanatory models 5 - Interpreter-mediated assessments 3 #### Geriatrics and Frailty (Core) 31 Atypical presentations, falls, delirium, polypharmacy, and disposition safety in older adults. - Atypical presentations and geriatric assessment - Atypical infection/ACS presentations 3 - Delirium recognition 3 - Disposition safety 3 - Frailty and functional assessment 4 - Polypharmacy and adverse drug events 3 - Falls and trauma in older adults - Disposition and safeguarding 3 - Head injury on anticoagulants 3 - Hip and pelvic fractures 4 - Rib fractures and respiratory compromise 2 - Syncope vs mechanical fall differentiation 3 #### High-Risk and Under-Served Groups (Advanced) 34 Clinical care tailored to specific physiologic and social contexts. - Care of patients with advanced cancer and comorbidities - Complications of therapy affecting other organs 4 - Decision-making under limited prognosis 2 - Infection risk management 4 - Transitions to hospice 3 - Patients with serious mental illness - Capacity and adherence challenges 3 - Delirium vs psychiatric symptom overlap 2 - Metabolic monitoring for antipsychotics 2 - Suicide risk in medical illness 3 - Patients with substance use disorders and complex illness - Hospital-based addiction care 3 - Infections related to injection drug use 3 - Pain management with OUD 3 - Trauma-informed care 2 #### Immunocompromised Patients (Core) 26 Oncology, transplant, HIV, and iatrogenic immunosuppression presentations and ED priorities. - Oncologic and therapy-related complications (intro) - Disposition 2 - Immunotherapy adverse events awareness 3 - Spinal cord compression awareness 3 - Thrombosis/PE risk in cancer 3 - Tumor lysis syndrome awareness 2 - Fever in immunocompromised patients - Disposition 2 - HIV and opportunistic infection awareness 3 - Neutropenic fever 2 - Steroid/biologic immunosuppression 3 - Transplant patient infection risk 3 #### Intellectual disability, autism, and communication differences 18 Adapting assessment and treatment for neurodevelopmental and cognitive differences across lifespan. - Challenging behavior and risk management - Positive behavior support planning 4 - Psychotropic use: target symptoms and monitoring 3 - Diagnostic overshadowing and medical contributors - Communication-adapted interviewing 6 - Pain, constipation, seizures, sleep problems 5 #### LGBTQ+ and gender-related mental health care 16 Affirming assessment, minority stress, gender dysphoria-related care principles, and psychiatric com... - Gender dysphoria care principles (within psychiatrist scope) - Assessment and comorbidity evaluation 4 - Collaborative care with gender-affirming services 5 - Minority stress and stigma-related mental health risks - Assessment of discrimination, violence, and support 4 - Suicide risk and protective interventions 3 #### Pediatrics 80 Age-specific assessment, stabilization, and high-risk pediatric presentations. - Febrile infant and pediatric sepsis (foundational) - Disposition 4 - Empiric antibiotics 5 - Initial evaluation 4 - Pitfalls 3 - Risk stratification concepts by age 4 - Pediatric assessment and physiology essentials - Age-adjusted vitals and shock recognition 4 - Fever and serious bacterial infection risk 5 - Pain assessment and analgesia 3 - Pediatric airway differences 4 - Safeguarding basics 5 - Pediatric dehydration and GI illness - Assessment of dehydration 4 - Disposition 3 - Electrolyte derangements awareness 4 - Oral rehydration therapy (ORT) 4 - When to suspect surgical abdomen 5 - Pediatric respiratory distress syndromes - Bronchiolitis 4 - Croup 4 - Disposition and family counseling 3 - Foreign body aspiration 3 - Pediatric asthma 5 #### Perinatal and reproductive psychiatry 16 Assessment and treatment planning around pregnancy, postpartum, lactation, and reproductive transiti... - PMDD and reproductive transitions - Diagnosis and treatment overview 4 - Perinatal mood and anxiety disorders - Medication risk-benefit counseling 4 - Safety planning and mother-infant considerations 3 - Screening and differential diagnosis 5 #### Pregnancy and Gynecologic Emergencies (Core) 86 Physiologic changes, early pregnancy complications, and common OB/GYN emergencies in the ED. - Second/third-trimester bleeding (overview) - Disposition and transfer 4 - Pitfalls 4 - Placenta previa/abruption awareness 5 - Postpartum hemorrhage awareness 5 - Preterm labor awareness 6 - First-trimester bleeding and ectopic pregnancy - Complications and pitfalls 5 - Disposition 4 - Initial evaluation 4 - Management pathways 5 - Ultrasound interpretation (conceptual) 4 - Hypertensive disorders of pregnancy (core) - BP management principles 3 - Disposition 3 - HELLP syndrome awareness 3 - Magnesium sulfate therapy 3 - Preeclampsia/eclampsia recognition 5 - Pregnancy physiology and ED implications - Cardiovascular/respiratory changes 5 - Disposition and follow-up 4 - Laboratory and imaging considerations 6 - Resuscitation modifications 4 - Trauma considerations 4 #### Safeguarding, Social Determinants, and Vulnerable Groups 42 Discharge planning and safety for patients with social vulnerability or safeguarding needs. - Homelessness, substance use, and high-utilization care - Behavioral health comorbidity 4 - Documentation and ethical considerations 2 - Harm reduction in ED 2 - Linkage to care and follow-up 3 - Medical risks and barriers 3 - Patients with disabilities and communication barriers - Capacity and consent considerations 2 - Communication accommodations 2 - Discharge planning 2 - Pitfalls 3 - Safeguarding and abuse risk 2 - Domestic violence and sexual assault (core) - Forensic pathways awareness 3 - Mandatory reporting (contextual) 3 - Medical care essentials 4 - Safety planning and resources 4 - Trauma-informed care 3 #### Severe psychosocial vulnerability and marginalized contexts 16 Homelessness, incarceration, HIV, chronic pain, and other contexts requiring adapted and equitable c... - HIV and neuropsychiatric complications - Depression, cognitive impairment, medication interactions 5 - Incarcerated individuals and reentry planning (overview) - Continuity of care and medication access 3 - Chronic pain and opioid risk - Integrated pain and mental health care 4 - Homelessness and serious mental illness - Engagement and harm reduction 4 ### Toxicology And Environmental 198 questions #### High-Yield Pharmaceutical and Drug Exposures 131 Common ingestions and toxidromes frequently tested in EM boards. - Beta-blocker and calcium channel blocker toxicity - Disposition 3 - Initial management 5 - Pitfalls 4 - Recognition and ECG findings 4 - Specific therapies (awareness) 5 - SSRIs, serotonin syndrome, and neuroleptic malignant syndrome - Differential diagnosis 4 - Disposition 5 - NMS recognition 5 - Serotonin syndrome recognition 4 - Treatment 5 - Acetaminophen toxicity - Disposition 5 - Pitfalls 5 - Risk assessment by timing and dose 5 - Treatment 5 - Workup 5 - Opioids and sedative-hypnotics - Benzodiazepine overdose 5 - Disposition 4 - GHB and other club drugs (awareness) 3 - Naloxone strategies 5 - Opioid overdose recognition 4 - Salicylate poisoning - Clinical pattern and mixed acid-base 5 - Diagnostics 4 - Dialysis indications awareness 4 - Disposition 4 - Treatment 4 - Tricyclic antidepressants (TCA) and sodium-channel blockers - Clinical and ECG features 4 - Disposition 3 - Pitfalls 5 - Refractory shock/arrhythmia rescue (awareness) 4 - Treatment 4 #### Toxicology Approach and Antidotes 67 Toxidromes, decontamination, antidote principles, and coordination with poison centers. - Decontamination strategies - Activated charcoal 3 - Dermal/ocular decontamination 5 - Enhanced elimination (awareness) 5 - Gastric lavage (rare) awareness 3 - Whole bowel irrigation (WBI) awareness 5 - Antidote principles and high-yield antidotes - Antidote awareness set (board-level) 5 - Fomepizole for toxic alcohols 4 - N-acetylcysteine (NAC) for acetaminophen 5 - Naloxone 4 - Sodium bicarbonate for sodium-channel blockade 4 - Initial approach to the poisoned patient - Consultation and disposition 5 - History and exposure assessment 4 - Key diagnostics 5 - Stabilization (ABCDE) and glucose 5 - Toxidrome recognition 5 ### Trauma And Injury 288 questions #### Orthopedic Injuries and Soft Tissue Trauma 103 Fractures, dislocations, compartment syndrome, wounds, and burns. - Burns and thermal injury - Burn depth and TBSA estimation 4 - Fluid resuscitation (conceptual) 4 - Inhalation injury recognition 5 - Initial burn management 4 - Transfer to burn center criteria 4 - Compartment syndrome and crush injury - Crush syndrome and rhabdomyolysis 5 - Disposition 3 - Fasciotomy timing and outcomes (conceptual) 4 - Measurement and consultation 4 - Recognition and exam pitfalls 4 - Dislocations and reduction complications - Ankle and subtalar dislocation 5 - Elbow and knee dislocations (high-risk) 4 - Hip dislocation (time-critical) 3 - Post-reduction care 4 - Shoulder dislocation 5 - Fracture evaluation and immobilization principles - Closed reduction indications (intro) 5 - Disposition and follow-up 3 - Imaging strategy 4 - Neurovascular assessment 4 - Open fractures 3 - Soft tissue injuries, bites, and infection risk - Animal and human bites 5 - Disposition and follow-up 4 - Lacerations and tendon injuries 4 - Necrotizing soft tissue infection red flags 4 - Puncture wounds and foreign bodies 5 #### Safeguarding and Injury Prevention 65 Non-accidental trauma, interpersonal violence, and safeguarding responsibilities. - Elder abuse and neglect awareness - Disposition 4 - Medical evaluation 5 - Pitfalls 4 - Red flags 5 - Reporting and safeguarding 3 - Intimate partner violence (IPV) and sexual violence (initial approach) - Disposition and resources 4 - Forensic considerations (awareness) 5 - Mandatory reporting and legal interface (contextual) 3 - Medical evaluation and treatment basics 5 - Trauma-informed screening and response 4 - Non-accidental injury (NAI) and child abuse recognition - Differential diagnosis pitfalls 4 - Disposition 3 - Mandatory reporting and safety planning 5 - Red flags in history and exam 6 - Workup and documentation 5 #### Trauma Systems and Initial Management 120 Assessment, imaging choices, stabilization priorities, and early trauma decision-making. - Abdominal and pelvic trauma - Blunt abdominal trauma 6 - Disposition 5 - Genitourinary trauma awareness 5 - Pelvic fracture and hemorrhage 4 - Penetrating abdominal trauma (overview) 4 - Cervical spine and spinal cord injury - Pain control and safe mobilization 4 - Pitfalls 5 - Spinal cord injury syndromes 5 - Spinal immobilization and clearance 5 - Thoracolumbar injury and cauda equina 5 - Thoracic trauma - Imaging and disposition 4 - Life-threatening chest injuries 4 - Penetrating chest trauma 5 - Pulmonary contusion and flail chest 5 - Rib fractures and pain control 4 - Trauma primary survey and resuscitation priorities - ABCDE with hemorrhage control 5 - Analgesia, sedation, and hemodynamics 5 - Disposition/transfer to trauma center 5 - Mechanism of injury and occult injury risk 5 - Trauma imaging strategy (conceptual) 5 - Traumatic brain injury (TBI) and head trauma - Concussion and mild TBI 5 - Disposition and observation 5 - Intracranial hemorrhage patterns 6 - Moderate/severe TBI stabilization 5 - Skull and facial fractures 4 Emergency Medicine Advanced Pathway ### Clinical Decision Making 68 questions #### Advanced Diagnostic Reasoning and Risk Stratification 68 High-order decision-making, dynamic reassessment, and defensible disposition in complex and uncertai... - Disposition under uncertainty and safety-netting (advanced) - End-of-life decisions in ED context 3 - Managing “bounce-back” risk 2 - Observation medicine design 3 - Shared decision-making for discharge of borderline risk 3 - Transfer decisions and risk balancing 2 - Dynamic differential diagnosis and reassessment - Diagnostic time-outs and cognitive forcing strategies 3 - Documentation of evolving reasoning 3 - Managing conflicting data 3 - Serial exams as a diagnostic tool 3 - Trajectory-based reasoning 2 - Evidence-informed decision tools (advanced use and limitations) - Balancing sensitivity with downstream harms 3 - Bayesian framing at bedside 3 - Defensible documentation 2 - Integrating patient values 3 - When decision rules apply vs do not apply 4 - High-risk complaint pathways (advanced application) - Abdominal pain with diagnostic uncertainty 3 - Chest pain with nondiagnostic testing 2 - Dyspnea with mixed etiologies 2 - Headache with negative initial imaging 2 - Syncope risk and disposition (advanced) 3 - Managing multiple simultaneous patients and ED prioritization - Documentation strategy in high-volume settings 3 - Interruptions and task switching 3 - Queue management and prioritization heuristics 2 - Situational awareness in evolving events 3 - Team utilization and delegation 3 ### Clinical Subspecialties 391 questions #### Communication and Collaboration 41 Advanced communication performance in conflict, uncertainty, and interprofessional teamwork. - Communicating uncertainty and shared decision-making (advanced) - Challenging behaviors and de-escalation 3 - Culturally safe and equitable communication 4 - Discharge communication excellence 3 - Informed refusal and capacity under stress 2 - Risk communication techniques 3 - Delivering bad news and death notification - After-death care and support 2 - Conflict and blame prevention 2 - Family presence and cultural considerations 4 - Personal resilience and support 3 - Structured approach and empathy 3 - Managing conflict with consultants and teams - Documenting disagreements 2 - Escalation frameworks 3 - High-stakes handoffs 3 - Negotiating shared plans 2 - Team dynamics in resuscitation 2 #### Medical Toxicology (Advanced) 83 Complex overdose management, uncommon tox syndromes, and antidote escalation decisions. - Envenomation and exotic exposures - Marine envenomation and toxin fish (awareness) 4 - Plant and chemical exposures (awareness) 3 - Public health and consultation 2 - Snakebite management 3 - Spider/scorpion and arthropod syndromes (awareness) 3 - Sports Medicine and Environmental/Undersea Medicine (Advanced) - Altitude illness awareness 3 - Concussion and return-to-play/return-to-learn 4 - Diving and decompression illness awareness 2 - Exertional heat illness in athletes 3 - Hyperbaric indications and transfer coordination 2 - Complex mixed overdoses and tox consultation - Advanced diagnostics and monitoring 3 - Disposition planning 3 - Documentation and poison center collaboration 2 - Escalation therapies awareness 4 - Pattern recognition in mixed toxidromes 3 - Neurocritical Care and Stroke Systems (Advanced) - Intracerebral hemorrhage management details 2 - Large vessel occlusion (LVO) identification and pathway 3 - Refractory status epilepticus (advanced awareness) 2 - Sedation and neuro exam balance 2 - Subarachnoid hemorrhage and vasospasm awareness 3 - Pain Medicine and Substance Use Care (Advanced) - Chronic pain, frequent visitors, and care plans 3 - Complex pain and opioid-tolerant patients 3 - Ethical prescribing and safety 2 - Opioid use disorder (OUD) ED initiation pathways 2 - Regional anesthesia expansion 2 - Pediatric Emergency Medicine (Advanced) - Congenital heart disease emergencies (awareness) 3 - Critically ill child approach 3 - Pediatric respiratory failure and ventilation 3 - Pediatric sepsis and meningitis 3 - Pediatric trauma and safeguarding 3 #### Prehospital and Disaster 46 EMS medical direction, transfer medicine, and major incident management. - EMS medical direction and protocol oversight - Documentation and medico-legal interface 3 - Field triage and destination decisions 4 - Online medical control communication 3 - Protocol development principles 2 - Safety and scene considerations 3 - Interfacility transfer and retrieval medicine - Choosing transport modality and team 3 - Special transfers 4 - Stabilization before transfer 3 - Transfer documentation and handoff 3 - Transport risks and mitigation 2 - Mass casualty incidents (MCI) and disaster triage - CBRN and hazmat response basics 3 - Incident command principles 4 - MCI triage systems awareness 3 - Public health emergencies and outbreaks 3 - Surge capacity and ED operations in disasters 3 #### Professionalism and Ethics 50 High-stakes professional practice: law interfaces, privacy, restraint, reporting, and ethical resour... - Ethics of resource scarcity and triage - Bias mitigation in triage decisions 2 - Communication with patients/families 2 - Crisis standards of care awareness 2 - ED boarding and competing priorities 2 - MCI ethical dilemmas 2 - Privacy, confidentiality, and information sharing - Digital documentation and imaging 3 - ED confidentiality principles 3 - Ethical pitfalls 3 - Law enforcement interface 3 - Mandatory disclosures (exceptions) awareness 3 - Capacity, consent, and refusal in complex cases - Capacity in intoxication and delirium 3 - Documentation for legal scrutiny 2 - Minors and confidential care 2 - Refusal of lifesaving care 3 - Surrogate conflict and family disputes 2 - Restraint, agitation, and mental health law interfaces - Disposition and continuity 2 - Least-restrictive intervention framework 3 - Legal holds and documentation (contextual) 2 - Medical evaluation of agitation 3 - Monitoring and complications 3 #### Scholarship and Education 58 Evidence-based practice, research literacy, teaching, assessment, and lifelong learning/CPD. - Scholarship, research methods, and ethics - Academic professionalism 3 - CPD and lifelong learning 4 - Knowledge translation and dissemination 4 - Protocol and project design basics 2 - Research ethics and consent 3 - Guideline implementation and quality improvement (QI) - Equity-focused QI 2 - Patient safety event analysis 3 - QI methods and measurement 2 - Sustaining change 3 - Translating guidelines into pathways 3 - Teaching and feedback in Emergency Medicine - Assessment literacy (boards/orals/OSCE) 3 - Bedside teaching models 3 - Feedback and coaching skills 3 - Procedural teaching and supervision 3 - Simulation-based education 4 - Critical appraisal and clinical epidemiology (advanced) - Applying evidence at bedside 2 - Diagnostic studies and prediction rules 3 - Interpreting RCTs and pragmatic trials 3 - Observational studies and causal inference 2 - Systematic reviews/meta-analysis interpretation 3 #### Special Populations (Advanced) 70 High-complexity scenarios in pregnancy, pediatrics, geriatrics, immunocompromised, and palliative ca... - Palliative care and end-of-life emergencies - Communication skills 3 - Disposition planning 2 - Ethical dilemmas and conflict 2 - Rapid goals-of-care conversations 3 - Symptom control in ED 3 - Critically ill neonate/child (advanced) - Complex safeguarding cases 3 - Family communication under crisis 3 - Neonatal resuscitation crossover essentials 2 - Pediatric airway failure and RSI nuances 3 - Pediatric shock and sepsis escalation 2 - Geriatric critical illness and anticoagulation complications - Delirium and agitation in elderly (advanced) 3 - DOAC/warfarin bleeding and reversal decisions 3 - Elder abuse and neglect complex cases 3 - End-of-life in older adults 3 - Falls with occult injury and frailty 3 - High-risk pregnancy resuscitation and emergencies - Disposition and medico-legal communication 4 - Eclampsia and severe preeclampsia crisis 3 - Obstetric hemorrhage initial management 3 - Perimortem cesarean delivery awareness 2 - Pregnancy airway and ventilation challenges 3 - Immunocompromised/oncology/transplant emergencies (advanced) - Advanced hematologic emergencies 3 - Disposition and infection control 3 - Neutropenic sepsis escalation 3 - Oncologic airway/SVC syndrome awareness 2 - Transplant complications awareness 3 #### Systems Leadership 43 ED flow, governance, quality improvement, and leading multidisciplinary teams during routine and sur... - Leading teams and managing performance - Conflict resolution and professionalism enforcement 2 - Equity and inclusion leadership 3 - Surge events leadership 3 - Teaching and supervision in a busy ED 4 - Team leadership behaviors 2 - Clinical governance and risk management - Credentialing, supervision, and scope management 3 - Guideline implementation and standardization 3 - Incident review and root cause analysis (RCA) concepts 2 - Managing complaints and adverse events 3 - Medicolegal risk mitigation 3 - ED flow and crowding mitigation - Communication during surge 3 - Input-throughput-output framework 3 - Metrics and performance dashboards (awareness) 3 - Operational prioritization and resource allocation 3 - Safety in crowding 3 ### Communication And Collaboration 13 questions #### Advanced Communication Skills 13 Category placeholder to maintain structure; see 'Communication and Collaboration' above for detailed... - Advanced communication comprehensive review - Agitation and de-escalation communication 2 - Bad news and death notification 2 - Communicating uncertainty and shared decisions 3 - Conflict and negotiation with teams/consultants 3 - Equity-centered communication 3 ### Prehospital And Disaster 18 questions #### Prehospital Systems and Disaster Operations 18 Category placeholder to maintain structure; see 'Prehospital and Disaster' above for detailed topics... - Prehospital and disaster comprehensive review - CBRN/hazmat/public health emergencies 4 - EMS medical direction 3 - Interfacility transfer/retrieval 3 - MCI/disaster triage and command 4 - Systems integration 4 ### Procedures And Ultrasound 145 questions #### Advanced Procedures Under Time Pressure 82 Procedural performance expected in oral/OSCE-style assessments, including complication handling. - Regional anesthesia and nerve blocks (ED) - Complications 2 - Documentation and aftercare 3 - Indications and block selection 3 - Local anesthetic dosing and LAST 3 - Technique and ultrasound guidance awareness 2 - Advanced procedural sedation and analgesia - Documentation and discharge criteria 2 - Medication strategy by procedure 3 - Monitoring and adverse event management 3 - Risk stratification and airway planning 3 - Special populations considerations 3 - Advanced vascular access and monitoring - Arterial line placement (advanced awareness) 3 - Central venous access with ultrasound 3 - Intraosseous access troubleshooting 3 - Medication infusion safety 3 - Ultrasound-guided peripheral IV mastery 3 - Cricothyrotomy and rescue airway skills - Complication management 3 - Indications in failed airway 2 - Post-procedure care 3 - Team leadership during airway crisis 2 - Technique performance 2 - Orthopedic procedures (advanced) - Arthrocentesis and septic joint management 3 - Compartment syndrome serial exams 3 - Complex reductions and immobilization 3 - Post-procedure care and disposition planning 3 - Traction splinting and temporary stabilization 2 - Thoracic procedures (advanced) - Complication recognition and rescue 3 - Needle decompression technique optimization 2 - Pericardiocentesis (awareness to performance) 2 - Thoracentesis (diagnostic/therapeutic) 3 - Tube thoracostomy and pigtail placement 4 #### Point-of-Care Ultrasound (Advanced Integration) 63 Acquisition, interpretation, and management integration of core POCUS applications and ultrasound-gu... - Early pregnancy and pelvic POCUS - Documentation and QA 3 - Ectopic suspicion signs 2 - Gynecologic emergencies awareness 3 - IUP identification and limitations 3 - Pregnancy of unknown location (PUL) management integration 2 - Cardiac POCUS and shock integration (RUSH) - Clinical integration and documentation 2 - IVC and volume assessment limitations 3 - LV/RV function gross assessment 2 - Pericardial effusion/tamponade assessment 2 - Views and image acquisition 2 - eFAST and abdominal vascular ultrasound - AAA ultrasound 3 - Biliary ultrasound 3 - DVT ultrasound (compression) 3 - eFAST performance and pitfalls 3 - Hydronephrosis and renal ultrasound 2 - Lung ultrasound and respiratory failure - Diaphragm and work of breathing awareness (low) 3 - Documentation and workflow integration 2 - Interstitial syndrome and pulmonary edema 3 - Pleural effusion and consolidation 2 - Pneumothorax detection 2 - Ultrasound-guided procedures - Documentation and safety 3 - Soft tissue ultrasound for abscess 3 - US-guided nerve blocks awareness 2 - US-guided thoracentesis/paracentesis awareness 3 - US-guided vascular access 2 ### Professionalism And Ethics 37 questions #### Advanced Ethics in Complex Internal Medicine 23 Difficult cases, interprofessional tensions, and high-risk legal/ethical scenarios. - Ethics consultation triggers and frameworks - Documentation and communication 4 - Ethics in resource limitation 2 - Identifying ethical dilemmas 2 - Structured analysis 3 - Professionalism in difficult interactions - Conflicts of interest in leadership roles 3 - Equity and bias in professionalism 3 - Interprofessional conflict resolution 3 - Managing disruptive behavior 3 #### High-Stakes Professional Practice 14 Category placeholder to maintain structure; see 'Professionalism and Ethics' above for detailed topi... - Professionalism and ethics comprehensive review - Capacity/consent/refusal complex cases 3 - Confidentiality and law enforcement interface 3 - Ethics of resource scarcity and triage 3 - Professional documentation under scrutiny 2 - Restraint and mental health law interfaces 3 ### Resuscitation And Critical Care 163 questions #### Advanced Airway Management 41 RSI optimization, difficult airway algorithms, and peri-intubation risk reduction. - Difficult airway prediction and planning - Airway assessment frameworks 3 - Airway plan A/B/C/D 3 - Failed airway and rescue sequence 3 - Peri-intubation hemodynamic optimization 3 - Preoxygenation optimization 4 - Rapid sequence intubation (RSI) pharmacology and strategy - Airway complications management 2 - Induction agent selection 3 - Neuromuscular blockade selection 2 - Peri-intubation hypoxemia management 2 - Post-intubation analgesia/sedation bundles 2 - Surgical airway (advanced performance) - Complications and troubleshooting 3 - Indications and timing 2 - Pediatric considerations (awareness) 3 - Team and CRM during CICO 3 - Technique mastery (scalpel-bougie-tube) 3 #### Hemodynamics, Shock, and ED Critical Care 53 Advanced shock management, monitoring, vasopressor infusions, and ED-based critical care workflows. - Advanced shock differentiation and monitoring - Dynamic fluid responsiveness concepts 3 - ED-ICU workflow and reassessment cadence 2 - Hemodynamic targets by shock type 2 - Invasive monitoring awareness 3 - RUSH/POCUS-guided shock evaluation 3 - Cardiac arrest and post-arrest critical care - Advanced ACLS leadership 3 - Neuroprognostication timing awareness 2 - ROSC stabilization 3 - Special arrest scenarios 3 - Targeted temperature management (TTM) awareness 3 - Sepsis and septic shock (advanced) - Antibiotic strategy under uncertainty 3 - Early recognition in atypical patients 3 - Fluids and de-resuscitation awareness 2 - Sepsis documentation and quality measures pitfalls 2 - Source control coordination 3 - Vasoactive infusions and pressor selection - Adjuncts and second-line agents 3 - First-line pressors by syndrome 3 - Peripheral pressor administration safety 3 - Refractory shock escalation 2 - Titration and monitoring 2 #### Neurocritical emergencies 29 Advanced stabilization for elevated ICP, status epilepticus, and neurovascular catastrophes. - Elevated intracranial pressure and herniation syndromes - Airway/ventilation strategy 2 - Clinical recognition 4 - Imaging and definitive management coordination 3 - Immediate temporizing measures 3 - Pitfalls 3 - Status epilepticus refractory management (advanced awareness) - Airway and sedation strategy 2 - Complication management 3 - Disposition 3 - Escalation beyond second-line agents 3 - Identifying underlying cause quickly 3 #### Ventilation and Respiratory Failure Management 40 Mechanical ventilation/NIV strategies, ARDS principles, and ventilator troubleshooting. - Mechanical ventilation initial settings and physiology - Lung-protective ventilation principles 2 - PEEP titration and hemodynamics 2 - Post-intubation care bundle 3 - Ventilation in ARDS/pneumonia 2 - Ventilation in obstructive disease 3 - Non-invasive ventilation (NIV) advanced application - Contraindications and failure recognition 4 - Escalation to intubation 3 - Selecting CPAP vs BiPAP 3 - Special scenarios 3 - Titration and monitoring 2 - Ventilator troubleshooting and emergencies - Approach to sudden deterioration on vent 3 - Auto-PEEP and breath stacking 3 - High pressure alarms 2 - Low pressure alarms 3 - Post-intubation hypotension and arrest prevention 2 ### Scholarship And Education 37 questions #### Advanced Educator and Scholar Competencies 22 Programmatic assessment, learning science, and scholarship dissemination. - Learning science and curriculum design (overview) - Cognitive load and instructional design 2 - Competency-based medical education (CBME) 3 - Faculty development and coaching 3 - Simulation-based education 3 - Scholarly writing and dissemination - Academic career development 3 - Educational scholarship 3 - Presentation skills 3 - Writing for publication 2 #### Scholarship, EBM, Teaching 15 Category placeholder to maintain structure; see 'Scholarship and Education' above for detailed topic... - Scholarship and education comprehensive review - Assessment literacy for orals/OSCE 3 - CPD and lifelong learning 3 - Critical appraisal and EBM application 4 - QI and guideline implementation 2 - Teaching and feedback skills 3 ### Special Populations 396 questions #### Advanced Special Population Integration 14 Category placeholder to maintain structure; see 'Special Populations (Advanced)' domain set above. - Integrated advanced special populations review - Critically ill neonate/child 3 - Geriatric frailty and anticoagulation complications 3 - High-risk pregnancy emergencies 3 - Immunocompromised/oncology emergencies 3 - Palliative and end-of-life care 2 #### Cultural, linguistic, and refugee mental health 17 Culturally safe care, interpreter use, trauma and displacement, and diagnostic adaptations. - Refugee trauma and complex needs - Care coordination with social/legal supports 5 - Pre-, peri-, post-migration stressors 4 - Cultural formulation and culturally bound expressions - Eliciting explanatory models 5 - Interpreter-mediated assessments 3 #### Geriatrics and Frailty (Core) 31 Atypical presentations, falls, delirium, polypharmacy, and disposition safety in older adults. - Atypical presentations and geriatric assessment - Atypical infection/ACS presentations 3 - Delirium recognition 3 - Disposition safety 3 - Frailty and functional assessment 4 - Polypharmacy and adverse drug events 3 - Falls and trauma in older adults - Disposition and safeguarding 3 - Head injury on anticoagulants 3 - Hip and pelvic fractures 4 - Rib fractures and respiratory compromise 2 - Syncope vs mechanical fall differentiation 3 #### High-Risk and Under-Served Groups (Advanced) 34 Clinical care tailored to specific physiologic and social contexts. - Care of patients with advanced cancer and comorbidities - Complications of therapy affecting other organs 4 - Decision-making under limited prognosis 2 - Infection risk management 4 - Transitions to hospice 3 - Patients with serious mental illness - Capacity and adherence challenges 3 - Delirium vs psychiatric symptom overlap 2 - Metabolic monitoring for antipsychotics 2 - Suicide risk in medical illness 3 - Patients with substance use disorders and complex illness - Hospital-based addiction care 3 - Infections related to injection drug use 3 - Pain management with OUD 3 - Trauma-informed care 2 #### Immunocompromised Patients (Core) 26 Oncology, transplant, HIV, and iatrogenic immunosuppression presentations and ED priorities. - Oncologic and therapy-related complications (intro) - Disposition 2 - Immunotherapy adverse events awareness 3 - Spinal cord compression awareness 3 - Thrombosis/PE risk in cancer 3 - Tumor lysis syndrome awareness 2 - Fever in immunocompromised patients - Disposition 2 - HIV and opportunistic infection awareness 3 - Neutropenic fever 2 - Steroid/biologic immunosuppression 3 - Transplant patient infection risk 3 #### Intellectual disability, autism, and communication differences 18 Adapting assessment and treatment for neurodevelopmental and cognitive differences across lifespan. - Challenging behavior and risk management - Positive behavior support planning 4 - Psychotropic use: target symptoms and monitoring 3 - Diagnostic overshadowing and medical contributors - Communication-adapted interviewing 6 - Pain, constipation, seizures, sleep problems 5 #### LGBTQ+ and gender-related mental health care 16 Affirming assessment, minority stress, gender dysphoria-related care principles, and psychiatric com... - Gender dysphoria care principles (within psychiatrist scope) - Assessment and comorbidity evaluation 4 - Collaborative care with gender-affirming services 5 - Minority stress and stigma-related mental health risks - Assessment of discrimination, violence, and support 4 - Suicide risk and protective interventions 3 #### Pediatrics 80 Age-specific assessment, stabilization, and high-risk pediatric presentations. - Febrile infant and pediatric sepsis (foundational) - Disposition 4 - Empiric antibiotics 5 - Initial evaluation 4 - Pitfalls 3 - Risk stratification concepts by age 4 - Pediatric assessment and physiology essentials - Age-adjusted vitals and shock recognition 4 - Fever and serious bacterial infection risk 5 - Pain assessment and analgesia 3 - Pediatric airway differences 4 - Safeguarding basics 5 - Pediatric dehydration and GI illness - Assessment of dehydration 4 - Disposition 3 - Electrolyte derangements awareness 4 - Oral rehydration therapy (ORT) 4 - When to suspect surgical abdomen 5 - Pediatric respiratory distress syndromes - Bronchiolitis 4 - Croup 4 - Disposition and family counseling 3 - Foreign body aspiration 3 - Pediatric asthma 5 #### Perinatal and reproductive psychiatry 16 Assessment and treatment planning around pregnancy, postpartum, lactation, and reproductive transiti... - PMDD and reproductive transitions - Diagnosis and treatment overview 4 - Perinatal mood and anxiety disorders - Medication risk-benefit counseling 4 - Safety planning and mother-infant considerations 3 - Screening and differential diagnosis 5 #### Pregnancy and Gynecologic Emergencies (Core) 86 Physiologic changes, early pregnancy complications, and common OB/GYN emergencies in the ED. - Second/third-trimester bleeding (overview) - Disposition and transfer 4 - Pitfalls 4 - Placenta previa/abruption awareness 5 - Postpartum hemorrhage awareness 5 - Preterm labor awareness 6 - First-trimester bleeding and ectopic pregnancy - Complications and pitfalls 5 - Disposition 4 - Initial evaluation 4 - Management pathways 5 - Ultrasound interpretation (conceptual) 4 - Hypertensive disorders of pregnancy (core) - BP management principles 3 - Disposition 3 - HELLP syndrome awareness 3 - Magnesium sulfate therapy 3 - Preeclampsia/eclampsia recognition 5 - Pregnancy physiology and ED implications - Cardiovascular/respiratory changes 5 - Disposition and follow-up 4 - Laboratory and imaging considerations 6 - Resuscitation modifications 4 - Trauma considerations 4 #### Safeguarding, Social Determinants, and Vulnerable Groups 42 Discharge planning and safety for patients with social vulnerability or safeguarding needs. - Homelessness, substance use, and high-utilization care - Behavioral health comorbidity 4 - Documentation and ethical considerations 2 - Harm reduction in ED 2 - Linkage to care and follow-up 3 - Medical risks and barriers 3 - Patients with disabilities and communication barriers - Capacity and consent considerations 2 - Communication accommodations 2 - Discharge planning 2 - Pitfalls 3 - Safeguarding and abuse risk 2 - Domestic violence and sexual assault (core) - Forensic pathways awareness 3 - Mandatory reporting (contextual) 3 - Medical care essentials 4 - Safety planning and resources 4 - Trauma-informed care 3 #### Severe psychosocial vulnerability and marginalized contexts 16 Homelessness, incarceration, HIV, chronic pain, and other contexts requiring adapted and equitable c... - HIV and neuropsychiatric complications - Depression, cognitive impairment, medication interactions 5 - Incarcerated individuals and reentry planning (overview) - Continuity of care and medication access 3 - Chronic pain and opioid risk - Integrated pain and mental health care 4 - Homelessness and serious mental illness - Engagement and harm reduction 4 ### Systems Leadership 16 questions #### ED Leadership and Governance 16 Category placeholder to maintain structure; see 'Systems Leadership' above for detailed topics. - Systems leadership comprehensive review - Clinical governance and risk management 4 - ED flow and crowding 2 - Metrics and quality balancing 3 - Operations during disasters/surge 4 - 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