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April 2008 Challenge

48-year-old Amish female transferred via lifeflight after an auto vs. buggy accident. The patient is intubated at the scene for a GCS 6. Her vitals on arrival are as follows: BP-84/50, HR 142, RR- 20 (bagged) and PO-100%. On examination, she has multiple bruises noted on her torso and extremities. Her...

Posted to EMsono Challenge (Weblog) by Rob on 04-20-2008
Case of the Week - Case # 71

38-year-old female presents with right flank pain and vomiting. You are concerned she has a ureteral stone. You perform a bedside ultrasound and note the following... Take the Case

Posted to Cases (Weblog) by Rob on 04-12-2008
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...

Posted to Cases (Weblog) by Rob on 01-23-2008
Case of the Week - Case # 51

58-year-old male presents with nontraumatic right sided pain for the past 2 days. He points to the midaxillary line starting at @ the 8th intercostal space and extending caudal to the infracostal margin. He denies hematuria, fever, chills, n-v-d, fatty food intolerance, chest pain or dyspnea. His vital...

Posted to Cases (Weblog) by Rob on 11-16-2007
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
Case of the Week - Case # 48

A 26-year-old female who is 9.5 weeks pregnant by dates presents with right flank pain and vomiting. She denies fever, chills, hematuria, vaginal bleeding. Other than being pregnant, her PMH is unremarkable. On examination she appears mildly dehydrated but her vitals are stable. You are concerned that...

Posted to Cases (Weblog) by Rob on 10-24-2007
Case of the Week - Case # 47

28-year-old male with ESRF on HD presents with bilateral flank pain and concern for obstruction. Pt states his renal failure is due to childhood obstruction due to posterior urethral valves. He believes that his last CT scan showed small kidneys but no evidence of obstruction. The patient appears comfortable...

Posted to Cases (Weblog) by Rob on 10-15-2007
Case of the Week - Case # 39

28 yo hispanic female presents with acute right flank pain. She has no past medical history and her vital signs are stable. You are concerned that the patient has a kidney stone and you have the resident perform a bedside ultrasound. The resident tells you that she doesn't see any evidence of hydronephrosis...

Posted to Cases (Weblog) by Rob on 08-13-2007
Case of the Week - Case # 28

42 y.o. male who presents with right flank pain, nausea and vomiting. The patient has been hiking and camping for the last 2 days. He was in his normal state of health until 2 days ago when he developed sudden onset of right flank pain. Since then he has been unable to hold any fluids down. His vitals...

Posted to Cases (Weblog) by Rob on 05-26-2007
Case of the Week - Case # 24

A 7-year-old black female presents with severe right mid-abdominal tenderness that started at school and was associated with several episodes of vomiting. She was transported to the ED via EMS. On exam, the child was in obvious distress due to pain and did not want you to touch her abdomen. Her vitals...

Posted to Cases (Weblog) by Rob on 04-25-2007

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