Clinical Pearl August 21th

A 9 day old infant is brought to the ED with difficulty breathing and poor feeding for one day. Pt is found to be tachypneic, mottled, with peripheral cyanosis and no palpable LE pulses.  What’s your diagnosis? What should you do?Read more

Clinical Pearl

Review of Classif ication of Misscarriage: Threatened Ab:  3.4 to 17% with confirmed FHR by.  Rates higher without. References: Tannirandorn Y, Sangsawang S, Manotaya S, et al. Fetal loss in threatened abortion after embryonic/fetal heart activity. Int J Gynaecol Obstet 2003; 81:263. Schorge JO, Schaffer JI, Pietz J, Halvorson LM, Hoffman BL, Bradshaw KD, CunninghamRead more

Clinical Pearl: August 17th

60F with fatigue and decreased alertness.  What is the diagnosis?Read more

Clinical Pearl: August 16.

A nursing home patient presents critically ill with respiratory distress, severe abdominal distension, ascites and oliguria.  You are concerned for abdominal compartment syndrome. How will you make the diagnosis?Read more

Clinical Pearl: August 10

Look familiar? This is the yesterday’s ECG taken from Sgarbossa et al.  1996.  Is this a true LBBB?Read more

68F with chest pain.  No prior ECG. What is going on here?  Read more

A 29 y/o female with NIDDM and poorly controlled chronic asthma present s with 3days of sob and wheezing typical of her prior asthma exacerbations.  After two nebulizer treatments and dose of corticosteroids her PEFR is measured at 55% of predicted.  Should she be admitted?Read more

A 44 year old female with HTN, DM, and psychiatric disease presents with non-traumatic pain and vision loss in her right eye for 12 hours.  She has a right sided throbbing headache. On exam she has a 5mm R pupil which is sluggish to react, 3mm L pupil that is fully reactive. Her R eyeRead more

A 50 year old man presents with agitation and delirium.  He has sinus tachycardia to 120bpm but his vital signs are otherwise within normal ranges. He answers some questions, but is disoriented, illogical and rambling.  He is picking at “ants” crawling on his skin.  On physical exam you find bilaterally dilated pupils and his skinRead more