Category Name: em@3am

em@3am

EM@3AM: Placenta Previa

A 37-year-old G4P3003 female at 27 weeks GA presents via EMS for vaginal bleeding. She began having brisk vaginal bleeding after coitus about 30 minutes ago and has saturated 1 pad since onset. She denies associated abdominal pain, cramping, or prior episodes of vaginal bleeding during this pregnanc...

em@3am

EM@3AM: Paraphimosis and Phimosis

An 8-year-old male was brought in by his parents for continuous screaming for 12 hours. He is grabbing his groin area. He is in distress, and exam demonstrates incarceration of the glans by the foreskin with pronounced glans edema. His testicles appear normal. What’s the diagnosis, and what's your next step in evaluation and treatment?

em@3am

EM@3AM: Le Fort Fractures

An 28-year-old male presents after high-speed MVC with facial pain and loss of consciousness. He has severe facial pain and bruising, conjunctival hemorrhage bilaterally, and facial paresthesias. What is the patient’s diagnosis? What’s the next step in your evaluation?

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?