Gallbladder wall thickening

The normal gallbladder wall should measure less than 3-4mm. It is recommended that this measurement be taken through the anterior wall of the gallbladder, since posterior acoustic enhancement will often make posterior measurements inaccurat…

Clinical Pearl

38 yo M pmh brain ca currently under treatment p/w sob, tachpnea, and diaphoresis. You get an initial lactate 6.0 with a FS of 680. What is your diagnosis?

Effusion

Ultrasound is quite sensitive in detecting even very small pleural effusions; it has been demonstrated to perform better than chest x-ray and nearly as well as CT scan. In order to assess for pleural fluid, the transducer should be directed…

Clinical Pearl

30 yo M pmh ESRD 2/2 to lupus nephritis on HD p/w sob, tachypnea, and hypertensive not responding to Nitro gtt, lasix, or bipap. what emergent procedure will most likely help this patient?

Clinical Pearl

63 yo F  p/w AMS noted as AAOx2 w/o focal deficits. Pt appeared cachetic, thin, dry with following VS BP 148/70, HR 142, T 96.4, rr 20, o2 98%. EKG showed sinus tachy with noted persistent lactate 4-5 despite aggressive IVF and remained AMS…

Clinical Pearl

46 yo F pmh right carpal tunnel release 6 months ago presents with intermittent swelling, pain as in burning, feelings of warmth and cold, and hypersensitivity to right hand worsening over past 6 month. What is the diagnosis ? treatment?

Clinical Pearl

3 month old infant that was born full term, NSVD w/o complications presents with seizure like activity to your ED. Pt is afebrile with normal vitals however lethargic and not actively seizing. Off the blood gas you note a Na of 113. What mu…

Clinical Pearl

26 M pmh sickle cell disease p/w chest pain, sob, fever, and cough. She is noted to be hypoxic, anemic and has new pulmonary infiltrates on cxr. What diagnosis must be considered?   A: Acute chest syndrome “Acute chest syndrome i…

Clinical Pearl

  28 yo obese AA F pmh sickle cell disease comes in complaining of b/l leg pain similar to her prior pain crises. She states that she normally takes 8 mg morphine IV to control her pain however your hospital has a morphine shortage. Wh…

September 2012
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