November 2006 - Posts

• Clinical Case # 5

  A 24-year-old male presents to the ED after a GSW to the left flank with an entrance wound noted posteriorly and an exit wound noted anteriorly.  His vitals are stable and his examination is only remarkable for left flank and side tenderness.  His abdominal exam is benign. Your trauma surgeon wants you to perform a FAST exam to see if there is any intra-abdominal involvement.  You perform the FAST exam... Take the Case. Posted Nov 29 2006, 12:00 AM by Rob with no comments Filed under: FAST, Beginner, Intermediate, trauma

• Clinical Case # 4

  44-year-old female presents with right flank pain of two-months duration.  She was diagnosed with pyelonephritis six weeks earlier and urine culture revealed E. coli.  The patient could not afford the antibiotics and therefore has not been treated.  She relates having fevers on and off, chills and cloudy urine.  Her vitals are stable with an oral temperature of 38.4C.  Her physical exam reveals her to be ill-appearing.  Her urinalysis reveals 30-100 RBCs/HPF and greater than 100 WBCs/HPF.  You perform an ultrasound of her right kidney and note the following: Posted Nov 22 2006, 05:05 PM by Rob with no comments Filed under: Renal, Intermediate, Advanced, UTI

• Clinical Case # 3

  22 y.o. G1P0 female who is approximately 5.5 weeks pregnant by dates presents with spotting and suprapubic cramping. Her vitals are stable and her physical exam is unremarkable except for the mild suprapubic tenderness and minimal spotting. Her B-hCG is 3420 mIU/ml. You perform a transabdominal ultrasound examination... Take the clinical case  Posted Nov 15 2006, 12:00 AM by Rob with no comments Filed under: Pelvic, Beginner, OB, Pregnancy, Pelvic US

• Clinical Case #2

  A 55-year-old male was involved in a rollover MVC after his car was cut off by another vehicle.  The patient was retrained and is complaining of generalized abdominal pain, in addition to neck pain, back pain and extremity pain.  His vitals are stable upon arrival into the trauma room.  He has obvious deformities of his right humerus, left wrist and left femur.  He has no obvious thoracoabdominal trauma but has generalized abdominal tenderness.  After the initial stabilization, the patient’s blood pressure… Take the Case. Posted Nov 08 2006, 12:00 AM by Rob with no comments Filed under: FAST, Advanced, trauma

• Clinical Case # 1

  A 32 y.o. male presents after being stabbed in the R chest with a knife.  He is hemodynamically stable and has symmetric breath sounds on exam.  A chest x-ray cannot be immediately obtained... Take the case. Posted Nov 01 2006, 12:00 AM by Rob with no comments Filed under: FAST, Intermediate, trauma, lung