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em@3am

EM@3AM: Ovarian Torsion

A 30-year-old female presents to the ED with sudden onset right lower quadrant and flank pain. She has also had severe nausea and vomiting. Abdominal exam reveals significant right lower quadrant tenderness, and pelvic exam reveals tender right adnexa. What’s the next step in your evaluation and treatment?

em@3am

EM@3AM: Orbital Cellulitis

A 12-year-old male is brought to the ED by his mom for right eye swelling and pain. The patient reports pain with extra ocular motion and decreased vision in the right eye. You see extensive right eyelid swelling. What’s the next step in your evaluation and treatment?

em@3am

EM@3AM: Mesenteric Ischemia

A 65-year-old male with a history of paroxysmal atrial fibrillation presents with diffuse, severe abdominal pain after eating. He is not on anticoagulation. He has had some bloody stool. What do you need to consider, and what’s your next step in your evaluation and treatment?

em@3am

EM@3AM: Lyme Disease

A 35-year-old male presents for intermittent fevers, abdominal pain, and headaches for 3 weeks. On further questioning, he also states he has arthralgias. Review of systems is remarkable for a recent camping trip in the Boundary Waters Canoe Area of Minnesota. You find a bulls-eye rash on his trunk. What are your next steps?

em@3am

EM@3AM: Methanol Toxicity

A 62-year-old male brought in by EMS for altered mental status and complaints of visual disturbances. Per the EMS report, the patient had homemade moonshine found in his living room. The patient is confused and states his vision is globally diminished as if he were looking through a snowstorm. He also describes a headache and dizziness. What’s the diagnosis, and what’s your next step in your evaluation and treatment?

em@3am

EM@3AM: CNS Toxoplasmosis in HIV/AIDS

A 31-year-old male presents for headache for the past 72 hours. He has a history of tension headaches, but confirms that this headache feels different. He has a history of HIV/AIDS and is noncompliant with medications. His last known CD4 count one month prior was 200. He appears confused and is febrile. Neurologic exam reveals motor deficit of RUE and RLE. What's your next step?