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…
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…
Case courtesy of Joe Scofi. 65M history of CAD (on ASA/Plavix), HTN presents with 3 days of epigastric pain and “dark” stools. Denies history of GI bleed. He drinks and smokes. Says that he had a AAA repair in Russia thr…
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…
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 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…
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…
Today’s pearl was inspired by Vincent Roddy A 38-year-old man presents to the emergency department 6 weeks after Roux-en-Y gastric bypass with recurrent abdominal pain, nausea, and bilious vomiting. He has had 3 total episodes during…
