Thank you to Adam Vella for inspiring this clinical question.   What’s the deal with NSAIDs in pregnancy? Ibuprofen and naproxen are category B drugs in the 1st and 2nd trimesters. Catergory D in the 3rd. (aspirin is category D throughout pregnancy) We know NSAIDs are bad in the last trimester. They affect the kidney […]

What does the MI on the sidebar of the ultrasound machine screen stand for? The Mechanical Index is a safety metric which lets the operator know how much energy is being transmitted into the patient during sonography. Remember that sound is created by pressure waves,  so mechanical energy is transmitted into any object which receives […]

Courtesy of Jen Galjour. 28M presents obtunded. EMS reports open bottle of antifreeze next to patient on scene. Initial vitals are 98.0 130  90s/50s 37  96%.  Super stat shows pH 6.8, HCO3 8, lactate 12.  Patient is swiftly intubated. You initiate therapy for ethylene glycol poisoning. 1) Will fomepizole help this patient? 2) Will sodium […]

What does the TI on the sidebar of the ultrasound display stand for? Thermal Index (TI) is a biosafety metric used to describe the potential of the ultrasound beam to raise temperature in the path of the beam. It is the ratio of the power used by the machine to the power required to raise tissue temperature […]

A middle aged male p/w L-great toe pain for 3days, unresponsive to acetaminophen and ibuprofen. He denies fever or other complicating sx. On exam, the medial aspect of the L-great toe is erythematous w/TTP. No areas of fluctuance are appreciated. You need to remove this ingrown toenail. What’s your plan?