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Case of the Week - Case # 91

48-year-old male presents with severe upper abdominal pain that was sudden in onset. The patient has no PMH although he relates a history of heavy ETOH abuse. His vitals reveal a stable BP but the patient's heart rate is in the 130's. His abdominal exam reveals exquisite tenderness with guarding...

Posted to Cases (Weblog) by Rob on 09-02-2008
Case of the Week - Case # 90

A 54-year-old male presents with a significant UGI bleed. He seeks his care at an outside hospital and you have no records for him at your hospital. Due to his GI bleeding, you want to fluid resuscitate the patient but are concerned due to his CHF history. You perform a focused echo to assess for global...

Posted to Cases (Weblog) by Rob on 08-25-2008
July 2008 Challenge

54-year-old dialysis patient presents with left arm pain and swelling. His dialysis nurse sends him in because she is afraid to dialyze him from his AV graft in the left arm. The patient states that swelling has been present in the arm for a while but it has gotten worse recently and he is waiting to...

Posted to EMsono Challenge (Weblog) by Rob on 07-21-2008
May 2008 Challenge

A 22-year-old right-hand dominant male with known retained glass foreign bodies (fb) in his for two months duration. The patient has seen several hand surgeons and told it would be best to leave the fb's alone. The patient presents to the ED stating he can no longer perform his job duties due to...

Posted to EMsono Challenge (Weblog) by Rob on 05-13-2008
Case of the Week - Case # 73

74-year-old white female presents with dyspnea for two days. On examination, you notice that her heart sounds are muffled and you performed a focused ultrasound to assess for pericardial effusion... Take the Case

Posted to Cases (Weblog) by Rob on 04-30-2008
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...

Posted to Cases (Weblog) by Rob on 01-30-2008
Case of the Week - Case # 19

84 y.o. BF with history of HTN, CAD, CHF and A fib (on Coumadin) presents with nontraumatic right shoulder pain. Her vitals are stable and her temperature is 38.1 C. On physical examination, you note the obvious swelling of the right shoulder. She has good passive range of motion but it causes moderate...

Posted to Cases (Weblog) by Rob on 03-14-2007
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...

Posted to Cases (Weblog) by Rob on 11-22-2006

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