Clinical Pearl: July 24

A 14 year old male presents with gradual onset headache with blurry vision, photophobia, and right forearm “tingling.” He has had similar headaches previously, and this does not represent his worst headache. No neck stiffness. C…

Clinical Pearl: July 23

Interesting couple of pearls today regarding adenosine boluses for treatment of SVT courtesy of Bryan Hayes (@PharmERToxGuy). Standard dose is 6mg followed by 12mg, except under certain circumstances: The ingestion of caffeine prior to an a…

Clinical Pearl: July 20

A previously healthy young patient presents to the ED with sudden onset headache followed by progressive and profound altered mental status. You rush them to radiology for a head CT, which shows a large subarachnoid hemorrhage. Upon return…

Clinical Pearl: July 19th

A 29 year old soccer player presents to your ER with a shoulder deformity after falling backwards onto an outstretched arm. He has dislocated the same shoulder three times previously. What two specific lesions should you look for on the xra…

Clinical Pearl: July 17

An 11 day old infant presents to the ED with persistent emesis after every feed, along with progressive yellowing of skin since birth and a 30% weight loss since birth. Physical exam reveals normal vital signs and a jaundiced, slightly leth…

Clinical Pearl: July 13

A basic pearl for today : A quick review of hepatitis B serologic markers. In addition to the chart below, consider the hepatitis B e antigen (HBeAg), which is generally considered a marker of infectivity, as the protein is creating during…

Clinical Pearl: July 12

A 55 year old male with ESRD on peritoneal dialysis (PD) presents with fever and abdominal pain, reporting cloudy-appearing effluent today from his PD port. You are concerned, appropriately, that the patient has peritonitis. Since the patie…

Clinical Pearl: July 6

A 66 year old female patient presents to the ED with a transient episode of dizziness and SOB earlier today. PMH notable for stage III CKD, DM, HTN. She takes valsartan, metformin, and is currently on TMP-SMX (Bactrim) for a UTI. Her EKG sh…

Clinical Pearl: July 5

A 4 year old child presents to the ER with 7 days of a measured fever, along with a progressive diffuse red maculopapular rash over the trunk and extremities. On exam, the patient has a conjunctivitis and erythematous oral mucosa. What diag…

Clinical Pearl: July 3

A 50 year old patient with HIV, HCV cirrhosis presents to the emergency room with subjective fevers and generalized abdominal pain with tenderness. As part of your workup, you plan for a diagnostic paracentesis. On ultrasound imaging, the p…

December 2022
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