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…
39 y/o M no significant past medical history presents with severe right sided occipital headache since this morning. The pain comes and goes, lasting a few minutes each time. He has had these headaches before, and feels that this episode…
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…
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…
A 12 year old patient with sickle cell disease presents to the ED with painful erection x 5 hours. Urology is paged and suggests fluids, high flow oxygen, compresses to the area and exchange transfusion. They do not wish to aspirate blood…
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…
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…
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…
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.
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…
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?
Premature neonate resuscitation pearls courtesy of Dr. Jennifer Sanders. Neonates have a high surface area to volume ratio and thin underdeveloped skin – this results in rapid heat and fluids loss. There are many documented ways to ma…
A young emergency medicine nurse asks you to take a look at a rash she has developed over the last 2 weeks. She noted a single lesion on her back which is painless and not pruritic approximately 10 days ago (see below). She developed anoth…
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…
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…