Things That Make Your Heart Slow Down…

Which conditions cause relative bradycardia?   a. Typhoid fever (Salmonella typhi) b. Malaria c. Legionnaire’s disease (Legionella pneumophila) d. Rocky Mountain Spotty Fever e. Infectious mononucleosis f. Pneumonia 2/2 Chlamydia g. SIRS h. Hantavirus  Read more

Kitty Bites Cat Lady

30 yo F presents c/o bite wound to her face by her pet cat. The cat was nervous because she was in a new home, otherwise the cat did not exhibit any unusual behavior and has all its vaccines. The patient is uptodate with vaccines as well. The bite occurred just prior to arrival. OnRead more

Can I Use That Central Line?

All of us have placed central line before.  You enter the vein under ultrasound. The wire threads easily, or maybe there is a little resistance, but the wire passes anyway.  You dilate, place the catheter and suture it in place.  You then order a chest x-ray, already confident the line is in the right place.Read more

Scuba Do

A 33 yo  man presents to the ED with multiple complaints 2 hours after completing a scuba dive.  Which of the following symptoms indicates a need for recompression therapy? Decreased hearing Ear pain Epistaxis Knee pain Petechial rashRead more

My Aicd Won’t Stop Firing!

65 yo M PMH of HTN, CAD, CHF (EF <30%), AICD wheeled into the cardiac room saying that he is getting shocked every 30 seconds. Vitals: T 36 HR 45 BP 205/100 RR 30 O2 sat 100% RA. Pt is placed on a monitor, EKG done which shows atrial fibrillation with slow ventricular rate.  ARead more

Ouch, My Back

34 yo M BIBA s/p fall from 3 stories, suicidal attempt. Pt is AO3, CTA b/l, pelvis stable, able to lift all extremities off stretcher, sensation and peripheral pulses intact. Pt has right lateral heel/ankle deformity. +step off L1-L2 area, good rectal tone. Red trauma was activated. CT shows compression fracture of L1 with loss of vertebral height ofRead more

Urinary Tract Infection & Pregnancy

An 8 month pregnant female arrives to the ED complaining about dysuria. She is nontoxic appearing, afebrile. Exam significant for +suprapubic tenderness, -CVA tenderness. UA +leuks, +nitrates. 1) What antibiotic regimen should she be started on as an outpatient? 2) What if she had fever, +CVA tenderness, or systemic findings consistent with pyelonephritis?   Options:Read more

Lovely Patagonia

32 yo M no sig PMH presents to ED with low grade, fevers, cough, SOB, and bodyaches for 4-5 days, symptoms are getting progressively worse. Pt had abdominal cramping, nausea, and diarrhea that preceded respiratory symptoms and began 1-2 weeks ago. He recently came back 2 days ago from Patagonia, Chile where he was campingRead more

More Than Just Teenage Angst

An 18 year old female presents to the ED with vague symptoms of lower back pain. She exhibited inappropriate and erratic behavior that seemed more than just teenage angst. The patient was thin in NAD and had a grossly normal musculoskeletal, motor and neuro exam, no red flags. Labs were drawn and she had aRead more