Resus SinaiEM Blog – Page 65

Of Things to Come…

Posted on February 28, 2014 by sinaiem

What ligament is commonly injured in the condition represented by the above xray. A.UCL B.PCL C.ACL D.LCL E.RCL Answer : A. UCL. This patient has a skier’s or gamekeeper’s thumb. The ligament damaged or torn is the Ulnar collateral ligament. The ED treatment is thumb spica, but if the ligament is torn completely, the […]

Rectum?

Posted on February 27, 2014 by sinaiem

A 70 year old male with a history of chronic constipation presents with abdominal pain. The patient has normal vitals. The xray below is taken. What is the treatment? A. Lactulose B.Straight to the OR for operative management C. Observation D. Barium Enema E. Rectal Tube Answer : E. If the patient […]

Give Me a Hand Here

Posted on February 25, 2014 by sinaiem

You are caring for an alcoholic well known to your emergency department. He presents with intoxication. His labs are normal, except for an EtOH level of 400. You monitor him for 8 hours and feed him. As you’re getting ready to discharge him, you get called away to a trauma. You come back 2 hours […]

A Shocking Development

Posted on February 24, 2014 by sinaiem

A 45 year old male playing tennis is struck by lightning and witnessed by bystanders. He is thrown several feet. He appears to be in cardiac arrest and CPR is started. After 5 minutes EMS arrives. His initial rhythm is asystole. His pupils are fixed and dilated. What is the next step in management? A.Amiodarone […]

Posted on February 21, 2014 by sinaiem

You are currently treating a patient in the ED for a TCA over dose. She has received bicarb, but go into a sustained ventricular tachycardia, with pulses. What is the next medication of choice A. Amiodarone B. Propranol C. Electricity D. Lidocaine E. Epinephrine F. Procainamide Answer – D. lidocaine is the antidysrhythmic […]

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Things That Make Your Heart Slow Down…

Posted on February 20, 2014 by santos

Which conditions cause relative bradycardia? a. Typhoid fever (Salmonella typhi) b. Malaria c. Legionnaire’s disease (Legionella pneumophila) d. Rocky Mountain Spotty Fever e. Infectious mononucleosis f. Pneumonia 2/2 Chlamydia g. SIRS h. Hantavirus

Wha Happened?

Posted on February 17, 2014 by sinaiem

A 19 year old female with a pmh of acne presents with the Emergency Department for the second time in 3 months with a complaint of epigastric pain. She states that the last episode resolved after 3 without speaking to her doctor. Her pain is accompanied with nausea and vomiting. She states that before these […]

Chest Pain

Posted on February 14, 2014 by sinaiem

A 65 year old Female Presents to the ED with a complaints of severe chest pain. Her medical history is significant for HTN, DM, HLD. The patient states the pain started after she was told Derek Jeter was going to retire Her EKG is below As the patient is being wheeled to the cath lab, […]

Whats the Difference?

Posted on February 13, 2014 by sinaiem

What is the Differential Diagnosis for the following EKg Differential Diagnosis of ST Elevation 1. Myocardial Infarction 2. Printzmetal’s angina 3. Male Pattern – being a man – the more manly, the higher the elevations 4. tako-tsubo–like left ventricular dysfunction 5. Pericarditis 6. Left Ventricular Hypertrophy 7. Early Repolarization 8. […]

Kitty Bites Cat Lady

Posted on February 8, 2014 by santos

30 yo F presents c/o bite wound to her face by her pet cat. The cat was nervous because she was in a new home, otherwise the cat did not exhibit any unusual behavior and has all its vaccines. The patient is uptodate with vaccines as well. The bite occurred just prior to arrival. On […]

Can I Use That Central Line?

Posted on February 3, 2014 by santos

All of us have placed central line before. You enter the vein under ultrasound. The wire threads easily, or maybe there is a little resistance, but the wire passes anyway. You dilate, place the catheter and suture it in place. You then order a chest x-ray, already confident the line is in the right place. […]

Last days of the stethoscope?

Posted on February 2, 2014 by phil

In the current issue of Global Heart (journal of the World Heart Foundation), several Mount Sinai authors have published articles on the use of point-of-care ultrasound. Phil Andrus wrote about focused cardiac ultrasound, Jennifer Huang co-authored a review of ultrasound use in IVC assessment, Daniel Lakoff described ultrasound incorporation into rapid response teams in inpatient […]

Scuba Do

Posted on January 30, 2014 by santos

A 33 yo man presents to the ED with multiple complaints 2 hours after completing a scuba dive. Which of the following symptoms indicates a need for recompression therapy? Decreased hearing Ear pain Epistaxis Knee pain Petechial rash

My Aicd Won’t Stop Firing!

Posted on January 27, 2014 by santos

65 yo M PMH of HTN, CAD, CHF (EF <30%), AICD wheeled into the cardiac room saying that he is getting shocked every 30 seconds. Vitals: T 36 HR 45 BP 205/100 RR 30 O2 sat 100% RA. Pt is placed on a monitor, EKG done which shows atrial fibrillation with slow ventricular rate. A […]

Can’t Put My Finger on It

Posted on January 24, 2014 by schnapp

A 29 year old male resident presents to the local emergency department directly from the residency ski trip. He was cruising down the slopes at high speed, hit a hidden patch of ice and fell onto his right hand, hyperextending his thumb. He tried to avoid coming to the emergency department, but the thumb remains […]