Rachel Bridwell

EM@3AM: Lyme Disease

A 35-year-old male presents for intermittent fevers, abdominal pain, and headaches for 3 weeks. On further questioning, he also states he has arthralgias. Review of systems is remarkable for a recent camping trip in the Boundary Waters Canoe Area of Minnesota. You find a bulls-eye rash on his trunk. What are your next steps?

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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 also describes a headache and dizziness. What’s the diagnosis, and what’s your next step in your evaluation and treatment?

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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?

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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 recent dental infection of his right bottom molar. What’s the primary concern, and what’s your next step in your evaluation and treatment?

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EM@3AM – Electrical Injuries

A 34-year-old male presents to the emergency department following a “shock” to the hand. Per the patient, while installing a ceiling fan thirty minutes prior to arrival, he experienced the sudden onset of severe pain in his right hand when it made contact with an exposed wire. He is currently asymptomatic. Is an evaluation warranted? Let’s take a look at this week’s review of electrical injuries.

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