Category Name: em@3am

em@3am

EM@3AM: Inflammatory Bowel Disease

32-year-old male presents to the ED with vomiting and abdominal cramping. He has Crohn's disease and has been poorly compliant with his medications. His current episode began as right lower abdominal pain 1 week ago with several episodes of watery diarrhea daily. He developed diffuse cramping, naus...

em@3am

EM@3AM: Myxedema Coma

A 43-year-old female presents with altered mental status.  Her husband states she has had weight gain, constipation, fatigue, and skin changes. Vital signs include BP 92/60, HR 48, T 93.2 rectal, RR 13, SpO2 96% on room air. She is alert and oriented x 1, and her neck reveals a well-healed midline ...

em@3am

EM@3AM: Jaundice in Adults

A 53-year-old male presents with nausea/vomiting and complains of turning “yellow”. He denies abdominal pain, fever, alcohol use, or acetaminophen intake. His vital signs are normal, and exam reveals icteric sclerae, jaundice of his face and chest, and hepatomegaly. He has no tenderness to abdominal palpation. What’s going on, and what’s your next step in evaluation and treatment?

em@3am

EM@3AM: Basilar Skull Fractures

A 19-year-old male presents after an MVC. Another passenger reports that the patient hit his head on the seat in front of him. His GCS is 12, and you find hemotympanum, serosanguineous discharge bilaterally from the nares, and CN III palsy on exam. What’s the next step in your evaluation and treatment?

em@3am

EM@3AM: Hyper- and HypoCa

A 59-year-old male with history of CML presents to the emergency department with left sided flank pain. He was sitting in a chair 4 hours ago when the pain suddenly started. The pain has been constant since onset. He appears uncomfortable, with mild tenderness in the LLQ. Testicular exam is normal. What is your presumed diagnosis, and what is the most likely contributor?

em@3am

EM@3AM: Post-Tonsillectomy Complications

An 8-year-old male presents 7 days post-tonsillectomy. His mother states he started spitting up blood this morning. The patient appears well, but suddenly starts throwing up coffee ground emesis. When the patient stops throwing up, you look at the back of the throat and see what appears to be a clot. What’s the next step in your evaluation and treatment?

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?