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 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…
The incidence of hemorrhagic complications from large volume paracentesis (LVP) is unknown but hemoperitoneum from rupture of mesenteric varices is associated with a high mortality up to 70%. Signs and symptoms of hemorrhage can manifest fr…
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…
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…
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…
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…
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…
What ligament is commonly injured in the condition represented by the above xray. A.UCL B.PCL C.ACL D.LCL E.RCL Answer : A. UCL. This patient has a skier’s or gamekeeper’s thumb. The ligament damaged or torn is the Uln…
A 70 year old male with a history of chronic constipation presents with abdominal pain. The patient has normal vitals. The xray below is taken. What is the treatment? A. Lactulose B.Straight to the OR for operative managemen…
You are caring for an alcoholic well known to your emergency department. He presents with intoxication. His labs are normal, except for an EtOH level of 400. You monitor him for 8 hours and feed him. As you’re getting ready to dis…
A 45 year old male playing tennis is struck by lightning and witnessed by bystanders. He is thrown several feet. He appears to be in cardiac arrest and CPR is started. After 5 minutes EMS arrives. His initial rhythm is asystole. His pu…
You are currently treating a patient in the ED for a TCA over dose. She has received bicarb, but go into a sustained ventricular tachycardia, with pulses. What is the next medication of choice A. Amiodarone B. Propranol C. Electricity D….
Which conditions cause relative bradycardia? a. Typhoid fever (Salmonella typhi) b. Malaria c. Legionnaire’s disease (Legionella pneumophila) d. Rocky Mountain Spotty Fever e. Infectious mononucleosis f. Pneumonia 2/2 Chlamydia…
A 19 year old female with a pmh of acne presents with the Emergency Department for the second time in 3 months with a complaint of epigastric pain. She states that the last episode resolved after 3 without speaking to her doctor. Her pain…
