Bundle Branch Blocks

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’s a quick and easy way to differentiate the two in most cases. Look atRead more

Should You Stop Metformin After Iv Contrast?

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 increased blood levels of Metformin. Metformin + IV contrast = lactic acidosis = bad   This was the reasoning to having patientsRead more


Bedbug bites Pruritic, urticarial papules most frequently on exposed areas Often linear configuration of 3-4 lesions (“breakfast, lunch, and dinner”. Ew.) Tx: corticosteroids + antihistaminesRead more

Vbg Vs. Abg

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) published in American Journal of Emergency Medicine in 2012 found that with aRead more

Red Eyes

Hyphema (RBCs in anterior chamber): from trauma, inflammation, pathologic neovascularization  Read more

Meningitis Pearls

How do I interpret WBCs in a traumatic tap?Read more

A psych patient with abdominal tenderness and distention has the following abdominal film. Which drugs are radiopaque on xray?   Read more

An upset mother arrives in the Peds ED saying that her 2 yo son swallowed one of her “pressure pills.” Which antihypertensives can be single dose killers for a young child?Read more

What is NUTTV1? Read more