48 y/o M presents after dredging for clams off the coast of Long Island. He reports finding a metallic object in his net, then throwing it overboard. Over the next two hours he develops the following…. What’s the diagnosis?
5 y/o F presents to the ED feeling “uneasy.” She is noted to have a pulse of 140 and BP of 180/110 and is profusely sweating. She is on imipramine for bedwetting, no other PMH. Pupils are PERRL. Exam is otherwise unremarkable. CBC, BMP, UA…
47 y/o female PMH appendectomy presents with three days of worsening abdominal pain and constipation. Over the past day she has had persistent vomiting. She appears ill and has a diffusely tender abdomen. You quickly order labs and an obstr…
52 y/o female with a PMH of HTN and HLD presents with mental status change over the past 12 hours. She is non-compliant with medications and her initial BP is 252/130. Physical exam shows pt is A&Ox1, with an otherwise normal neuro exam…
75 y/o M with a past medical history of atrial fibrillation presents to the ED not feeling well for several days. He has some diarrhea but has continued to take his medications. He is mildly hypotensive. While IV access is established, you…
51 y/o M with a hx of smoking and HTN presents with acute onset of chest pain…. Is this anteroseptal ischemia or posterior MI?
You have just intubated a 65 year old woman with sudden respiratory failure. On arrival, she had a pulse but cool extremities. She was obtunded and agonal with SpO2 was in the high 70’s. After pre-oxygenating with BVM to 100%, the int…
You are on your PEM shift overnight when a 9 year old boy with history of behavior disorder, BIBEMS only moments (<30min) after witnessed ingestion of 500mg of his grandmother’s amitriptyline. On arrival, ABC’s intact, and the patient is…
69 yo M with remote h/o CVA with residual aphasia and R–sided hemiparesis, BIBEMS from NH with concern for status epilepticus (SE). Per EMS, the patient began to have 3-4 episodes of generalized convulsive activity that began about 30 minut…
You are catching up on some charts in the resuscitation area of your ED when your triage nurse pushes in a 37 yo M with no PMHX, who presented to your ED complaining of sudden onset lightheadedness and L sided chest pain about 10 minutes PT…
A 19-year-old-male with no known past medical history, presents in progressive respiratory distress shortly after undergoing a tooth extraction about 6 hours prior to presentation. Symptoms began initially as “a lump in his throat” and diff…
44 yo F with h/o ESRD on HD and neurosarcoidosis complicated by panhypopituitarism on chronic steroids and thyroid replacement, BIBEMS obtunded. Last seen normal a few hours ago. The patient is hypotensive SBP ~75 and FSBG is undetectably l…
Over forty participants joined Sinai faculty Jim Tsung, Ee Tay, Bret Nelson, Joshua Guttman, Jacob Goertz, Turan Saul, Jenny Sanders, Kimberly Kahne, Michelle Vazquez, Joe Sorravit, and Rupi Mudan. Course Directors Ee Tay and Joshua Guttman…
54 yo F with no PMHx, but admittedly has not been seen by an MD in many years, presents after her daughter visited from our-of-town and found her slightly confused. The patient is disoriented, but able to provide some history. She describes…
56 yo F with no PMHX, presents complaining of increased DOE and orthopnea for several weeks. She also reports intermittent, mild mucosal bleeding. She denies syncope. Physical exam is notable for an obvious crescendo- decrescendo murmur ove…
