To Bleed or Not to Bleed

Extracranial internal carotid artery dissection can cause ischemic stroke by thrombus formation or thromboembolism and subsequent arterial occlusion.  In fact, it is the 2nd most common etiology of strokes in patients younger than 45 years….

Doppelgangers

Herpetic Whitlow –       Viral infection of hand caused by inoculation of HSV into broken skin Hand pain disproportionate to clinical presentation Associated with influenza-like illness Clear vesicles coalesce and become purulent but…

Blood Can Be Very Bad…indeed

Interpreting head CT’s can be daunting.  But it doesn’t have to be.  Just remember, “Blood Can Be Very Bad”. Blood –       blood up to 1 week old looks hyperdense to brain –       blood 1-4 weeks old looks isodense to brain…

L is for the Way You Lorazepam Me

Consider giving 2mg of lorazepam to your patient who’s back at baseline after one alcohol withdrawal seizure to possibly prevent recurrent seizures.  This may even save you an admission as long as the patient has been at baseline without si…

Elry…what!?!

Distinguishing early necrotizing fasciitis from severe cellulitis is difficult.  In 2004, Wong et al proposed the LRINEC(Laboratory Risk Indicator for Necrotizing Fasciitis) score as a means to distinguish necrotizing fasciitis from other s…

Yes We Can!

Yes in fact we do have a massive transfusion protocol in place at Sinai.  It’s quite amazing and surprisingly simple as long as the tubing system isn’t down.  Follow the following steps. Call 46101 Ask for “Massive Transfusion Pack” Provide…

Baby Momma Drama

As you know, pregnancy increases the risk of thrombosis.  This risk is even higher postpartum (within 6 weeks after giving birth).  Relative to the nonpregnant state, the 6 week postpartum period has been associated with 3-9 times risk of s…

Vf Arrest…simple Right? Maybe Not…

The vast majority of ventricular fibrillation arrest can be traced back to cardiac etiology (ie CAD, HOCM, myocarditis, etc). However there have been rare cases of v fib arrest secondary to nontraumatic SAH; one recently in our own backyard…

Correction

 cyproheptidine is a second-line therapy for serotonin syndrome. not SSRI overdose. the vast majority of SSRI overdoses do not result in serotonin syndrome. what kills people with serotonin syndromeis hyperthermia. the most important treatm…

There’s a Storm a Brewin’

When does one administer iodide as a treatment for thyroid storm? A.as soon as possible B.never C.it doesn’t matter D. 1 hour before administering a thionamide E. 1 hour after administering a thionamide F. 1 hour after administering a…

The Goggles…they Do Nothing!

  A patient presents with sudden onset eye pain.  He states he was watching his friend’s car get towed out of a snow drift that had suddenly appeared beneath it, when the towing cable snapped and the pain began.   He shows you th…

March 2014
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