32F no PMH, p/w fever and abdominal pain x 5 days. Seen 5 days ago at OSH and treated for UTI w bactrim. Seen 2 days later, switched to doxycycline for presumed PID. GC/chlamydia negative.  Returns today w persistent pain and fever. Pain is lower, bilateral, R>L with mild distention. No urinary or vaginal symptoms. […]

Kanavel’s sign: clinical sign found in patients with flexor tenosynovitis (infection of flexor tendon sheath of hand) –       involved digit kept in flexed position –       tenderness to palpation over tendor sheath –       pain with passive extension of digit –       fusiform swelling of digit     http://www.orthobullets.com/hand/6105/pyogenic-flexor-tenosynovitis

Ultrasound guided LP   Equipment needed: –       high-frequency (small parts linear probe) for patients with normal weight –       low-frequency 2-4 MHZ probe (abdominal curvilinear probe) for obese patients –       transducer gel –       skin marking pen –       LP tray   Positioning: left lateral decubitus or seated position   Technique: 1-   Identify spinous process which signifies the […]

10d male p/w R eye tearing and discharge x1 day. Today purulent. Born FT via NSVD, uncomplicated pregnancy and delivery. No fever. No vomiting, diarrhea. No URI. Taking good PO.  On exam, AFVSS, R eye diffuse soft tissue swelling, crusting to lashes, conjunctiva injected with purulent discharge:   Chlamydia Conjunctivitis in Newborn Transmission – from […]

55 yo F presents with shoulder pain after fall from bicycle: Also known as “luxatio erecta”  – to place upward   Inferior shoulder Dislocation     Mechanism of injury: fall and sudden grasp of object above head resulting in hyperabduction Presentation: Patients hold arm above head and is unable to adduct, looks like a person […]