An homage to my urologist husband: [spacer height=”20px”]A 30 yo male arrives to your trauma bay intubated after a high speed MVC. He has signs of head trauma, bruises and abrasions diffusely and…an erect penis. This should signal two initial thoughts in your mind: [spacer height=”20px”]1. First and foremost, spinal cord trauma. Priapism due to […]

A 52 year old male with a history of hypertension arrives to your ED presenting with similar symptoms as the patient you treated for a PE two days ago. CT scan is “rebooting.” So again, you empirically go for heparin. Soon after, you receive a phone call that CT is up and running and sprint-push […]

A 36 year old male with a history of protein C deficiency (not on AC) is wheeled into your resuscitation bay tachypneic, tachycardic and hypoxic one week after a major surgery. You throw on your ultrasound probe and see a ballooned-out right heart. CT is backed up even more than usual. Your suspicion for PE is […]

A classic tale: 24yoG2P1 at approximately 6 weeks by LMP presents with vaginal spotting. You perform your pelvic exam, noting scant bleeding and a closed os, followed by a bedside sonogram. But alas, you cannot find an IUP on your transabdominal exam and must move to the invasive intracavitary probe…and guess what, it’s dirty and […]

You call your COPD patient’s pulmonologist to chit chat about his current exacerbation and like a reflex, she recommends azithromycin. You’re like but what about antibiotic resistance? Does he really need antibiotics? What’s the deal? [spacer height=”20px”]Here’s the deal: [spacer height=”20px”]Macrolides are more than bacteria-killers, they also have been shown in countless studies to have immunomodulatory […]

We tend to think of pre-eclampsia as this dangerous yet somewhat nebulous hypertensive disorder in pregnancy that = OB consult, delivery. But what is the pathophysiology behind pre-eclampsia? And why the heck does it place one at risk for eclampsia? [spacer height=”20px”]1. Brief Pathophys, because it’s interesting! (Warning: the word trophoblast will make an appearance) [spacer […]

You are working in the resuscitation bay when EMS rolls in with a hypotensive, hypoxic, meekly responsive febrile patient. You are preparing to intubate and the nurse asks what medications you would like (note: everybody is looking at you). Blood pressure is 75/40. You pause briefly, an appropriate response, and consider your options for this hypotensive, likely […]

Holidays can be a tough time. They can even drive one to the bottle. But which bottle? If you suspect your intoxicated patient may have ingested an alcohol other than ethanol but want some quick answers in the form of serum labs tests (aka you do not want to wait until next Christmas for levels […]

With the advent of sepsis protocol masterminding, lactate has elbowed out the white blood cell count along with other parameters to become our primary measure of badness. But as we all know, while lactate elevation may indicate the severity of a patient’s sepsis, not all lactate elevations are due to sepsis. Let’s take a minute to remind […]