recent articles


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: 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?