Category Name: em@3am

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 al...

em@3am

EM@3AM: Hypoglycemia

A 27-year-old female with a history of insulin-dependent diabetes presents to the ED on a Friday evening somnolent and disoriented. Her coworkers report she started slurring her speech and became increasingly altered after they met at a bar after work.  Exam reveals a diaphoretic, obtunded female n...

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?

em@3am

EM@3AM: High-Pressure Injection Injury

A 43-year-old male right hand dominant man presents with pain and swelling of his left index finger. He is a professional painter and was using an industrial pain sprayer when he injected his left index finger. It now is exquisitely painful, with a large degree of swelling. What’s the diagnosis, and what’s your next step in your evaluation and treatment?

em@3am

EM@3AM: Intussusception

A 3-year-old male presents with his mom with chief complaint of vomiting and recurrent abdominal pain. Her son will intermittently cry and refuse to eat, followed by normal activity. His appetite has been decreased. VS are normal. Physical exam reveals a patient who appears stated age, nontoxic, and...

em@3am

EM@3AM: Ludwig’s Angina

A 28-year-old male presents for dysphagia and inability to handle secretions. His mouth hurts and noticed his neck looked larger than usual. He has been unable to eat for the past 12 hours due to pain with swallowing, drooling, and difficulty opening his mouth. Review of systems is remarkable for a ...

em@3am

EM@3AM: Idiopathic Thrombocytopenic Purpura

A 72-year-old male presents with fatigue for months. He sometimes has prolonged bleeding when he brushes his teeth. He denies weight loss, night sweats, or any other symptoms apart from his fatigue. He has no significant past medical or surgical history, and his VS are normal. Exam is unremarkable e...

em@3am

EM@3AM: Idiopathic Intracranial Hypertension

A 31-year-old female presents with headache. She has a history of migraines, but states that this headache is different. The headache came on over the past two days, but she has been having intermittent double vision when she changes positions, which is new. Exam reveals an obese female in no acute ...