January 2008 - Posts

• Case of the Week - Case # 61

  A 23-year-old female presents with vaginal bleeding and lower abdominal pain.  She is approximately 6 weeks pregnant by date and has a positive bedside UCG.  Her vitals are as follows: BP 88/46, HR 122, RR 24 and T 37.1C.  Her physical exam reveals moderate lower abdominal tenderness with guarding.  She has mild, nonclotted blood in the vaginal vault but bimanual examination is limited due to pain.  You are concerned about an ectopic pregnancy and perform a bedside ultrasound... Take the Case Posted Jan 30 2008, 09:36 PM by Rob with no comments Filed under: FAST, Pelvic, Intermediate, Advanced, Pregnancy

• Case of the Week - Case # 60

  A 44-year-old female presented to the ED with several day history of left flank pain, fever and malaise.  The patient relates a history of recurring UTIs but is on no antibiotic prophylaxis and denies history of recent hospitalization.  Her vitals signs are stable and she is noted to have a temperature of 100.8 F.  Her physical examination is only significant for left CVA tenderness.  Urinalysis reveals: >100 WBCs, 30-100 RBCs, large bacteria and a pH of 8.5.  Her creatinine was 1.3 and her WBC was 18.4. You perform a focused left renal ultrasound and note the following... Take the case Posted Jan 23 2008, 06:58 PM by Rob with 1 comment(s) Filed under: Renal, Intermediate, kidney, UTI

• Case of the Week - Case # 59

  A 24-year-old male presents with 5 days of left scrotal pain.  Pt states that the pain started suddenly 5 days ago.  He states he was seen at another hospital where an ultrasound revealed an epididymo-orchitis.  He has been treated with antibiotics and is concerned because he is not getting better.  He notices some pain with urination but no fever, chills, penile discharge or hematuria.  His vitals signs are stable and he is afebrile.  On examination, his left testicle is enlarged, firm, and tender.  His cremasteric reflex is absent on the left.  You perform an ultrasound and note the following... Take the Case Posted Jan 16 2008, 02:09 PM by Rob with no comments Filed under: Testicle

• Case of the Week - Case # 58

  A 41-year-old male presents with severe midepigastric abdominal pain and hypotension.  The patient states he has had no trauma and developed the pain 2 days ago and it has gotten progressively worse.  His vitals are as follows: BP 78/54, HR 138, RR 28 and T 38.1 C.  You perform a FAST exam in order to better evaluate this patient's hypotension.  On the perihepatic window you note the following... Take the Case Posted Jan 10 2008, 11:21 PM by Rob with no comments Filed under: FAST, Intermediate

• Case of the Week - Case # 57

  A 32-year-old male presents to the ED after being shot.  He has an entrance wound noted at the anterior axillary line near the lower costal margin.  An upright chest radiograph reveals no intrathoracic trauma.  The bullet's location is not seen on the chest radiograph.  The patient's vital signs are stable.  You are asked by the trauma surgeon to perform a FAST exam to see if the patient has hemoperitoneum in Morison's pouch. Take the Case Posted Jan 01 2008, 09:28 PM by Rob with no comments Filed under: FAST, Beginner, trauma