Category Name: em@3am

em@3am

EM@3AM: Myasthenia Gravis and Crisis

A 29-year-old female presents with generalized weakness and vision problems. The weakness is worse at the end of the day, and she has noted double vision. The symptoms worsen with heat. She denies any other neurologic deficits, including paresthesias. What is the likely diagnosis, and what is your next step in evaluation?

em@3am

EM@3AM: Pelvic Inflammatory Disease/Tubo-ovarian Abscess

A 23-year-old female presents with acute onset lower abdominal pain with abnormal vaginal discharge. She denies fevers, chills, nausea, vomiting, dysuria, hematuria, diarrhea, and constipation. She is sexually active with one partner of 3 months and inconsistently uses condoms. Speculum exam shows small amount of blood and cervical discharge. What is the likely diagnosis?

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...

em@3am

EM@3AM: Knee Dislocation

A 21-year-old male is brought to the ED by EMS after an MVC at 60 mph. He is complaining of severe right lower extremity pain, which EMS splinted. You find no other injuries on your exam, but upon removal of the splint, the patient has a clear deformity. You cannot detect a dorsalis pedis or posterior tibialis pulse on the right. What’s the next step in your evaluation and treatment?

em@3am

EM@3AM: Multiple Sclerosis

A 33-year-old female presents with blurry vision. She has also experienced intermittent paresthesias in her extremities and weakness. Your motor and sensory exam is normal, but you find internuclear ophthalmoplegia and an afferent pupillary defect. With these intermittent neurologic symptoms and ocular findings, what is the likely diagnosis, and what is your next step in evaluation?

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?