New Year’s Eye-ve

A 53 year old man presents with severe sudden onset pain in his left eye associated with nausea and cloudy vision. He describes seeing halos around lights. His symptoms started when he entered a dark nightclub where he was planning to celeb…

Nailed It

A 79 year old female presents the day after the New York Marathon, complaining of a painful R big toe. She wore old sneakers to run the race, her 50th marathon, and feels that her toe may have rubbed up against the toe box of the shoe. How…

Thumbs Up

A 25 year old rugby player presents with R thumb pain that began yesterday. She reports that she was trying to make a tackle and was stiff-armed. She fell to the ground, landing on an outstretched hand. Her pain is localized to the MCP join…

Hot Math

A 25 year old male was brought into the ED after his shirt caught on fire when he accidentally leaned back while sitting near a fireplace. He has partial-thickness burns on his entire back and the posterior aspect of both arms. He weighs 85…

Head Injury in Hemophilia

An 8 year old female is brought in by her mother after falling off her scooter one hour ago. She was not wearing a helmet, and hit her head on the ground. Patient and mother deny LOC. On exam, she is well-appearing, playing with her mother…

Zosyn = Nosyn

A 56 y/o male with poorly controlled diabetes s/p multiple toe amputations presents with several days of fever and foot pain.  He is tachycardic and hypotensive and appears to have an infected foot ulcer. Vascular surgery is paged, and agre…

Elmhurst Cqr Qtip

QTip: Some patients who are discharged with few or no diagnostics (e.g. xray) or treatments (e.g. antibiotics) feel as though their evaluation was inadequate. Taking an extra minute or two to explain why these interventions aren’t ind…

Aortic Dissection – A Covert Killer

Aortic dissections are insidious killers that are often undetectable by history and physical exam alone. Obviously, providers must have a high index of suspicion for these as their presentations are highly variable. CT angiography, and less…

Daily Pearl 12/13/13

Thanks to Dr. Kedia for today’s daily pearl: you have a patient with suspected anticholinergic overdose and a prolonged QRS. You give bicarbonate and it normalizes. You want to give physostigmine, but don’t know the contraindica…

Daily Pearl 12/12/13

A young woman presents with dysfunctional uterine bleeding. Exam is unremarkable and she has no concerning medical history. She has not symptoms of anemia. She asks about medications to control the symptoms.

Daily Pearl 12/9/13

A 50 year old male presents with sudden onset of severe right scapular / shoulder pain of 4 days duration. He denies cervical neck pain, no history of trauma, no recent surgeries. No fever/chills and no bad habits. On exam you note full ROM…

Daily Pearl 12/5/13

It’s time to start studying for the in-service exam. Eponymous fractures are some of the easier points. What are the two more common eponymous fractures of the forearm and how can you remember them?

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