To send home or not – AC in nephrotic syndrome

This deep dive came from a question posed during a morning report by Jackson. Jackson presented the case of a patient presenting with a swollen penis at MSBI, found to have low albumin and diagnosed with nephrotic syndrome. These patients are somewhat uncommon but come with interesting pathophysiology. The reason they present with edema and […]

Blood on the Dance Floor

We’ve all seen that movie where some old person coughs into a handkerchief and as the camera slowly pans away, there’s some blood stain. You know that guy isn’t making it to the end of the movie… Today, let’s talk about a less commonly featured troupe: Massive Hemoptysis Massive Hemoptysis is defined as hemoptysis > 1000ml […]

What with all these eyes?

As it may become very apparent, I take a lot of photos of interesting eye pathology. So what do you think is going on here? What if I told you that this had been going on for the past few days and they had been using steroid drops in the eye? No prior surgeries in this eye.  […]

Protect Your Neck…I Mean Esophagus

2 weeks ago, I had a patient presenting with an upper GI bleed. Despite aggressive treatment, the patient was still hypotensive and actively bleeding. Unfortunately, the GI fellow was on home call and further than expected from the hospital, but after telling him, “I’m placing a Blakemore,” he hurried in. That was a lie, I didn’t […]

Visual Diagnosis

What do you think is going on here? So if you were the resident who signed up for this patient what would you do? As may be obvious, this is herpes zoster ophthalmicus, which is a reactivation of the VZV in cranial nerve V ophthalmic division. It’s a can’t miss visual diagnosis. Patients most at […]

GI Decontamination

Case: 37-year-old M presenting with obtundation and possible seizure-like activity after a large overdose of sustained-release bupropion (Wellbutrin XL), gabapentin, and other unknown medications. Given the severity of this patient’s overdose, he was intubated for airway protection and for further GI decontamination, including gastric lavage, activated charcoal, and whole bowel irrigation. Overview Given that GI […]

Shoulder Reductions

So today, we’re gonna talk about shoulder dislocations. This should resonate with a lot of you residents considering the weather conditions currently, or if you were worried about what would happen if a certain SuperBowl performer were to have fallen: If a shoulder dislocation is suspected, make sure a thorough neurovascular exam is conducted! Are the […]

Flail Chest

An uncommon injury caused by three or more rib fractures in two places Injury resulting from blunt trauma such as a motor vehicle accident (75%), falls (15%) or direct percussion to the chest Causes decrease intrathoracic pressure, ineffective ventilation, and pulmonary contusion Pulmonary contusion is causes by small laceration of the alveoli leading to blood […]

Procedural Sedation and Analgesia (PSA)

It’s winter and nobody has shoveled the roads; everyone and their mama is slipping. You have a patient with an obvious ankle dislocation and ortho is requesting that you put the patient to sleep so they can yank on the foot in peace without all that bothersome screaming. Ortho is requesting propofol but you are […]

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