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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
March 2008 EMsono Challenge

32-year-old female presents to the ED with RUQ abdominal pain and jaundice. She denies any chronic medical conditions and does not take any medications. She admits to tobacco use but denies other drug use. She appears obviously jaundiced but is otherwise nontoxic and has stable vital signs. Her physical...

Posted to EMsono Challenge (Weblog) by Rob on 03-25-2008
Case of the Week - Case # 66

An 87-year-old female nursing home resident presents to the ED hypotensive after a fall. The patient has a history of organic brain syndrome, a fib on coumadin, hypertension, coronary artery disease, hypothyroidism and gout. The patient is nonverbal. Her vitals signs are as follows: BP 62/40, HR 108...

Posted to Cases (Weblog) by Rob on 03-04-2008
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
January 2008 EMsono Challenge

A 43-year-old female presents to the ED with sudden onset of dyspnea and left sided chest pain. The patient tells you she just underwent a TAH for uterine fibroids and was discharged home 5 days ago. The patient denies other past medical history although she relates having a spontaneous pneumothorax...

Posted to EMsono Challenge (Weblog) by Rob on 01-09-2008
December 2007 EMsono Challenge

5 week old male child presents with three days of non-bloody, non-bilous emesis. The mother states she feeds the child only 1 ounce at a time and he has emesis after each feeding which is "projectile". Mother denies fever, irritability, lethargy, and the patient is otherwise well. The mother...

Posted to EMsono Challenge (Weblog) by Rob on 12-26-2007
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...

Posted to Cases (Weblog) by Rob on 12-03-2007
Case of the Week - Case # 52

48-year-old white male presents to ED 5 days after crush injury at work with a heavy wooden box. For the past few days he has been experiencing worsening pain, redness and swelling in this right index finger. His vital signs are stable and he is afebrile. On examination, you notice fusiform swelling...

Posted to Cases (Weblog) by Rob on 11-26-2007
November 2007 EMsono Challenge

You are asked by one of your colleagues to scan a 22-year-old women who is 18 weeks pregnant. Her PMH is only significant for ureteral stones. She presented with fever of 103 F and right flank pain. Her urinalysis is consistent with a UTI and your colleague suspects pyelonephritis. He is concerned, however...

Posted to EMsono Challenge (Weblog) by Rob on 11-09-2007

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