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em@3am

EM@3AM: Pancytopenia

A 36-year-old male with a history of HIV presents to the ED complaining of dyspnea on exertion and fatigue. He is not compliant with his anti-retroviral medications. His conjunctivae are pale. There is a painful ulcer to the distal aspect of the tongue and scattered petechiae on his legs. Laboratory evaluation reveals WBC 2,000/microL, Hgb 8.5 g/dL, and platelets 90,000/microL. What do the exam and lab findings suggest?

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 except for one hemorrhagic bullae on his oral mucosa. He has no lymphadenopathy or hepatosplenomegaly. What are the next steps in management?

EMin5

EM in 5: NOACs – Novel Oral Anticoagulants

emDOCs would like to introduce a new series in association with creator and founder of EM in 5, Dr. Anna Pickens! We will be hosting videos from Dr. Pickens with links to further reading to provide focused visual and audio learning for those with a short time to obtain what you need for your next shift. Today EM in 5 covers NOACs.

FOAMED

The EM Educator Series: Bleeding until proven otherwise…

Welcome back to the EM Educator Series. These posts provide brief mini-cases followed by key questions to consider while working. The featured questions provide important learning points for those working with you, as well as vital items to consider in the evaluation and management of the specific condition discussed. This week we have a case where you should assume bleeding until proven otherwise.