A 62-year-old male presents holding a bloody wash cloth pinched over his nose spitting blood into a coffee mug.  His wife walks in behind him with a grocery bag full of medications.  Among them you recognize a common blood thinner. What is the diagnosis, and what are your next steps?

A 52-year-old male with a history of severe liver disease, cirrhosis, and hepatitis C presents with altered mental status. His vital signs are normal, and he displays asterixis on exam, with otherwise normal neurologic exam. His ECG, head CT, and labs are normal. What should you consider, and what are your next steps?

A patient walks into your ED with a shirt covered in blood. He’s actively vomiting. Your triage nurses quickly get him into a wheelchair and roll him back to one of your critical care booths. You have little time to act to stabilize this critically ill patient. What are your next steps?

An 18-year-old male has been found unresponsive in a house fire with severe burns. VS in the field include T 37.5C, BP 144/77, HR 110, RR 15, Pulse Ox 98% on RA. You have minutes to prepare your team to care for this patient. What’s your next step in evaluation and treatment?

A 57-year-old female presents with right sided headache and mild fever (100.8 F). You note an enlarged, tender temporal artery with beading on exam. She denies vision changes. What is the diagnosis, and what are your next steps?

A 26-year-old female presents with fevers and chills. She is febrile and tachycardic, with normal BP. You think you hear a murmur on exam, and on further questioning, she says she regularly uses IV drugs. What should you consider, and what are your next steps?

A 63-year-old female presents with nausea, vomiting, and altered mental status. Initial VS demonstrate BP 225/121, HR 88, 98% RA, T 98F, RR 18. What are your next steps?

A 23-year-old male is brought in by EMS with agitation. His VS include T 41 C, HR 133, BP 182/115, RR 26, D stick 118. EMS is concerned for ingestion, and the patient is not cooperative. What's your next step?