December 2007 - Posts

• Case of the Week - Case # 56

  A 24-year-old male presents to the ED with sore throat and muffled voice.  He has mild trismus and is handling his secretions well.  On examination, it was felt by the examining physician that the patient has a right peritonsillar abscess.  The ENT service was consulted.  After 3 attempts at needle aspiration, no pus is obtained and the ENT resident concludes that the patient only has a peritonsillar cellulitis and recommends discharging the patient home on augmentin.  You are asked to see the patient and to perform an ultrasound. Try the Case Posted Dec 24 2007, 01:29 PM by Rob with no comments Filed under: Intermediate, Procedural ultrasound

• Case of the Week - Case # 55

  An 86-year-old nursing home patient presents to the ED with dyspnea and low blood pressure.  Her EKG reveals low voltage QRS complexes and your resident is concerned that the patient has a pericardial effusion/tamponade.  Your resident is also concerned that "something doesn't look right in the right ventricle."  You perform a bedside ultrasound and note the following: Take the Case Posted Dec 17 2007, 01:16 AM by Rob with no comments Filed under: FAST, Beginner, Cardiac

• Case of the Week - Case # 54

  A 26-year-old male presents to the ED after a stab wound to the left chest.  The patient has stable vital signs and has diminished breath sounds on the left but the patient is splinting due to pain.  You and your resident perform a FAST exam and see no evidence of a pericardial effusion. During performance of a thoracic ultrasound for the detection of a pneumothorax, your resident comments that he sees a lung point.  What is your interpretation? Take the Case Posted Dec 10 2007, 09:19 AM by Rob with no comments Filed under: Intermediate, trauma, lung

• Case of the Week - Case # 53

  A 56-year-old male with PMH of chronic alcoholism and Hepatitis C presents to the ED with 2 days of right hand pain. Pt states he is not sure what happened. He remembers being in an altercation and being pushed down several steps. He adds that he is concerned that he was bit because the assailant had bitten him on his back last year during a fight. His vital signs are stable. His plain radiographs are negative for fracture or ROFB. His labs are normal with the exception of an elevated CRP and ESR. On examination, fusiform swelling of the right ring finger is noted with a wound note proximally. He is holding his finger in a preferred flexed position and is unable to completely straighten his finger. You consult the hand service due to your concern of a flexor tenosynovitis. The hand fellow forcibly straightens out the finger and states: "See this is just a simple cellulitis. Admit the patient to medicine." You perform a focused ultrasound and note the following: Take the Case Posted Dec 03 2007, 02:03 PM by Rob with no comments Filed under: Advanced, Musculoskeletal, Hand