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…
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…
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…
A 21 y/o M presents with chest pain and sudden syncope while walking to class earlier this morning. He had no other preceding symptoms. There was no seizure activity reported by witnesses. He denies any past medical or surgical history. He…
An infant is brought in with increased irritability x 2 days. The parents note that she hasn’t had any remarkable symptoms – no fever, cough, congestion, vomiting, diarrhea. She is tolerating feeds, but more fussy than usual. Your initial e…
A 14 y/o M presents to the ED complaining of severe intermittent low abdominal pain x 2 hours. His symptoms began after he awoke from sleep to urinate, and have been unremitting since. No history of trauma. He vomited once, 20 minutes prio…
Requested by Dr. Strayer as written by Dr. Porat – “As EMS was puling up someone came into the trauma bay and yelled “he just lost his pulse.” This gave me time to grab the thoracotomy tray and open it up. These extr…
You get a patient in triage with an anterior shoulder dislocation that happened 10 minutes prior to arrival. It’s happened to him multiple times on the same shoulder and all he did to dislocate it was to push up from a chair. You real…
We’ve all experienced it. There’s an intubated patient who is stable, saturating >98% on pulse ox, and then all of a sudden you hear the monitor start alarming and the SpO2 is plummeting. Lets assume that all other vitals are…
You get a EKG that’s a sinus rhythm but it has widened QRS waves. You remember learning about bundle branch blocks at some point back in medical school but thought it was confusing and never bothered to learn the difference. Here…
Metformin has been known to be associated with increased incidence of lactic acidosis. Metformin is renally excreted. Increased Metformin concentration leads to increased risk of lactic acidosis. IV contrast causes nephropathy leading to in…
Bedbug bites Pruritic, urticarial papules most frequently on exposed areas Often linear configuration of 3-4 lesions (“breakfast, lunch, and dinner”. Ew.) Tx: corticosteroids + antihistamines
You obtain a venous blood gas (VBG) on a patient with a COPD exacerbation because you are concerned about hypercarbia. You get a value of 55 mmHg. How correlative is that compared to an arterial blood gas (ABG)? A small study (n=89) publish…
Hyphema (RBCs in anterior chamber): from trauma, inflammation, pathologic neovascularization
How do I interpret WBCs in a traumatic tap?
