Thank you to Adam Vella for inspiring this clinical question. What’s the deal with NSAIDs in pregnancy? Ibuprofen and naproxen are category B drugs in the 1st and 2nd trimesters. Catergory D in the 3rd. (aspirin is category D t…
What does the MI on the sidebar of the ultrasound machine screen stand for? The Mechanical Index is a safety metric which lets the operator know how much energy is being transmitted into the patient during sonography. Remember that sound is…
Courtesy of Jen Galjour. 28M presents obtunded. EMS reports open bottle of antifreeze next to patient on scene. Initial vitals are 98.0 130 90s/50s 37 96%. Super stat shows pH 6.8, HCO3 8, lactate 12. Patient is swiftly intubated. You i…
What does the TI on the sidebar of the ultrasound display stand for? Thermal Index (TI) is a biosafety metric used to describe the potential of the ultrasound beam to raise temperature in the path of the beam. It is the ratio of the power u…
A middle aged male p/w L-great toe pain for 3days, unresponsive to acetaminophen and ibuprofen. He denies fever or other complicating sx. On exam, the medial aspect of the L-great toe is erythematous w/TTP. No areas of fluctuance are apprec…
A young lady presents to your ED a few hours after a fist fight, c/o L-eye pain. She does not wear contacts and has tried ice and ibuprofen for the pain but noticed her eye was very red, so she came in for help. You do a complete eye exam,…
A young lady is brought by friends on a makeshift stretcher. They have leaves in their hair and look frantic. They report that the patient went behind a tree to urinate, while on a hiking trip, and screamed after being bit on her L-forearm…
A middle aged man presents to the ED after almost 2days of penile pain and swelling. The sx started suddenly, during intercourse and he didn’t present until now 2/2 embarrassment. But now the pain has not abated, the condition has no…
An elderly man presents with new bloody urine x2days and abdominal distention/fullness. He noticed some clots prior to presentation and now hasn’t urinated x5hours despite a real urge to micturate. He has a h/o BPH and is on coumadin…
A middle-aged G3P2 presents at 19wks gestation c/o abd pain that started early this AM. She had some nausea but no vomiting, a subjective fever and no loose or frequent stools. Your differential is broad but at the top is appendicitis. You…
The subxiphoid four chamber view is commonly used in cardiac assessments and the FAST exam and for many is the initial “go-to” view of the heart. Difficulty obtaining this window can frustrate novice and seasoned operators, and…
