Daily Pearl

A 45F with a PSH of silicone breast implants in ’99 comes in to the ED after slipping on some ice and falling onto her chest.  She is concerned that an implant broke and that she’ll “get blood poisoning or cancer” if the implant isn’t…

Daily Pearl

Back to our patient from several days ago – 65M with HIV/AIDS, CD4 count 24, and prior CNS toxoplasmosis *compliant with his secondary prophylaxis treatment*, now BIBEMS for new AMS.  The head CT (WITH contrast) showed no new lesions,…

Daily Pearl

Matt Bai decided to get his cat a turkey for Thanksgiving and went off to Central Park with a bow and arrows to find one.  Unfortunately he just winged the biggest turkey, and it attacked and bit him.  He came into the ED wondering if he sh…

Daily Pearl

A 45M with no PMH is BIBEMS for AMS.  In the ED, he is obtunded with pinpoint pupils, respiratory depression, and an O2 sat of 90% on a NRB.  He does not respond to sternal rub.  His partner comes in and states that they were at a bar a few…

Daily Pearl

A 65M TCC resident with a PMH of HIV (CD4 count 24, VL 12K), cerebral toxoplasmosis in 2012, seizure disorder on keppra 1000mg BID, and endstage dementia was BIBEMS from TCC at noon for status epilepticus x 1.5 hours.  He had not had his an…

Daily Pearl

A 4 year old boy is brought into the peds ED for 4 days of profuse vomiting.  The mother reports that he has vomited 10-15 times per day, at first stomach contents but by now empty retching.  No F/C, no diarrhea, no urinary symptoms.  In fa…

Daily Pearl

You’re working in the resus room, and a code stroke is called in.  She arrives, and rather than any weakness, numbness, or facial droop, you see an elderly, unkempt woman who looks like she’s made of stone.  Her mouth is open an…

Qtips from Cqr

Elmhurst ER QTip: Once a study has been ordered, a multi-step process is initiated that may be difficult to interrupt. If, for example, a blood test is ordered but then deemed unnecessary, simply canceling the order in the physician order e…

Daily Pearl 11/11

A 58 y/o M presents to the ED with altered mental status. He smells of alcohol, appears drunk, and has a longstanding history of alcohol abuse. You obtain a serum alcohol level of 100. Further laboratory work up shows a pH 7.28 with CO2 53,…

Daily Pearl 11/8

A healthy nurse in a suburban community hospital presents reporting she thinks she has a positive PPD from a skin test that had been placed 48 hours ago. She has no known specific TB exposures. What finding is indicative of a PPD test in th…

Daily Pearl 11/5

A middle aged woman with schizophrenia presents to your ED on a cold night in February after being found stranded on a mountain where she became separated from her group of hikers during a snowstorm 2 days ago. You realize that this patient…

Daily Pearl 11/4

What 2 classic radiographic findings are exemplified in these images? What clinical diagnoses are they individually pathognomonic for? What clinical presentations would you expect?

Daily Pearl 11/1

    A 24 y/o M presents after running a marathon with diffuse myalgias and dark urine. He states he has been trying keeping up with hydration to the best of his ability, but it is an unseasonably warm November day. What is your le…

Ob-gyn Mcq

1. What is a not a common risk factor for PID (pelvic inflammatory disease)? (a) smoking (b) tampon use (c) multiple partners (d) young age (e) IUD 2. A 19 y/o G1 presents at 34 weeks gestation with BP 170/110, headache, and mild abdominal…

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