December 2006 - Posts

• Case of the Week - Case # 9

  A 23-year-old female who is 7 weeks pregnant presents with RLQ abdominal pain.  She has tenderness near McBurney’s point and you are suspicious for appendicitis.  Your surgical colleagues are not impressed and request that you perform “some form of imaging” to confirm the diagnosis.  You decide to perform a sonographic evaluation of the appendix and... Take the Case Posted Dec 27 2006, 12:00 AM by Rob with no comments Filed under: Intermediate, OB, Pregnancy, Appendicitis

• Case of the Week - Case # 8

  An 8-year-old male presents presents from the pediatric clinic with painful swelling of the right groin.  He had been seen also in the clinic by pediatric surgery and he was referred to the ED for further evaluation since the diagnosis could not be made with certainty by clinical examination.  The patient has no past medical history and appears nontoxic on examination.  The physical examination is only remarkable for the tender, non-fluctuant area in the right groin.  You perform a bedside ultrasound and you note the following... Take the Case Posted Dec 20 2006, 10:00 AM by Rob with no comments Filed under: Beginner, Musculoskeletal, Abscess, Foreign body

• Case of the Week - Case # 7

  A 34-year-old female presents with RUQ / midepigastric abdominal pain after eating dinner.  She denies history of chronic abdominal problems but states this pain has been recurring with increasing frequency lately and seems to be related to eating.  Her vitals are stable and her examination is only remarkable for the midepigastric and RUQ tenderness with guarding but no rebound.  Her ED labs are unremarkable.  You perform a focused GB exam and note the following:  Take the case. Posted Dec 13 2006, 12:06 PM by Rob with no comments Filed under: RUQ, Beginner

• Case of the Week - Case # 6

  A 27-year-old female without PMH who is pregnant (19w4d by dating from a 1st trimester OB ultrasound) presents with right flank pain and vomiting.  She was initially sent to L&D triage but is sent back to the ED since she is under 20 weeks.  Her vitals are stable (including fetal cardiac activity by hand-held Doppler) and she is afebrile.  Her exam is unremarkable except for right CVA tenderness. Her urinalysis reveals 30-100 WBCs/HPF, 5-10 RBCs/HPF, and large bacteria.  The ED resident you are staffing the case with performed a focused renal ultrasound due to concern of a possible ureteral stone... Take the Case. Posted Dec 06 2006, 12:00 PM by Rob with no comments Filed under: Renal, Pelvic, Beginner, Intermediate, OB, UTI, Pregnancy