A middle aged male p/w L-great toe pain for 3days, unresponsive to acetaminophen and ibuprofen. He denies fever or other complicating sx. On exam, the medial aspect of the L-great toe is erythematous w/TTP. No areas of fluctuance are apprec…
A young lady presents to your ED a few hours after a fist fight, c/o L-eye pain. She does not wear contacts and has tried ice and ibuprofen for the pain but noticed her eye was very red, so she came in for help. You do a complete eye exam,…
A young lady is brought by friends on a makeshift stretcher. They have leaves in their hair and look frantic. They report that the patient went behind a tree to urinate, while on a hiking trip, and screamed after being bit on her L-forearm…
A middle aged man presents to the ED after almost 2days of penile pain and swelling. The sx started suddenly, during intercourse and he didn’t present until now 2/2 embarrassment. But now the pain has not abated, the condition has no…
An elderly man presents with new bloody urine x2days and abdominal distention/fullness. He noticed some clots prior to presentation and now hasn’t urinated x5hours despite a real urge to micturate. He has a h/o BPH and is on coumadin…
A middle-aged G3P2 presents at 19wks gestation c/o abd pain that started early this AM. She had some nausea but no vomiting, a subjective fever and no loose or frequent stools. Your differential is broad but at the top is appendicitis. You…
The subxiphoid four chamber view is commonly used in cardiac assessments and the FAST exam and for many is the initial “go-to” view of the heart. Difficulty obtaining this window can frustrate novice and seasoned operators, and…
A middle aged man p/w constipation x4days, no n/v/fever. He is on methadone 120mg PO qday, chronically, 2/2 h/o IVDU. He has tried lots of OTCs, as well as prune juice and metamucil w/o relief. How can you help?
A middle aged woman p/w R-shoulder pain after falling on her outstretched arm. You order a plain film to eval for fracture or dislocation. What do you see?
A teenaged woman presents at 32weeks gestation, c/o fingertip pain after experiencing a brief electric shock at home. How do you evaluate and care for this patient?
A middle-aged lady presents to the ED but won’t tell the triage nurse what’s wrong. “I need to see a doctor, is all.” Turns out she has a rectal foreign body. On xray it appears to be an apple. On digital exam you ca…
How does kayexalate work? Is it useful in the ED?
How do you evaluate for an ectopic pregnancy (versus an intrauterine pregnancy)?
On April 18 the FDA released an alert regarding Other-Sonic Generic Ultrasound Transmission Gel, manufactured by Pharmaceutical Innovations Inc. The ultrasound gel was found to be contaminated with Pseudomonas aeruginosa and Klebsiella oxyt…
A young man presents with a slam dunk appendicitis. You start IV abx, order pre-op labs and request surg to come see the patient. Surgery chats with the young fellow, lays hands on his abd and reviews the labs and CT. They recommend IV abx…
