Category Name: em@3am

em@3am

EM@3AM: Tetanus

A 38-year-old male with a history of injection drug use presents with one day of progressively worsening, pressure-like chest pain radiating to his back. He appears diaphoretic and in moderate distress. He has had new difficulty opening his mouth. On exam, he is tachycardic, diaphoretic, and in acut...

em@3am

EM@3AM: Retropharyngeal Abscess

A 3-year-old male is brought in by his mother for severe throat pain and lethargy. She notes that he is playing less, refusing to eat, and preferring to lie supine. Review of systems is remarkable for a recent small fall with his toothbrush in his mouth. Triage vital signs include BP 91/49, HR 141, ...

em@3am

EM@3AM: Lemierre’s syndrome

A 23-year-old male presents for severe throat pain and cough. He states that his neck hurts, with left sided redness and pain. Vital signs include BP 91/49, HR 130, T 102.2 temporal, RR 25, SpO2 91% on room air. He appears toxic. The ENT exam reveals a midline uvula; soft mouth floor; prominent gene...

em@3am

EM@3AM: Pheochromocytoma

A 23-year-old male presents with recurrent episodes of global headache, flushing, sweating, and palpitations. These episodes first started 1 month ago. They occur several times per day and last less than one hour. He has also noted a 10-pound weight loss since these episodes started. Exam reveals b...

em@3am

EM@3AM: Immune-Related Adverse Event from Immune Checkpoint Inhibitors

A 43-year-old female with a history of breast cancer presents to the ED with diffuse abdominal pain and diarrhea for one week. She is experiencing over 12 episodes of non-bloody diarrhea daily. She is currently receiving Atezolizumab (Tecentriq) for breast cancer. Vital signs include BP 82/43, HR 1...

em@3am

EM@3AM: Celiac Disease

A 32-year-old female presents to the ED with worsening diarrhea for 2 months. The diarrhea is non-bloody but is bulky, foul-smelling, and floats. She has had a 9-pound weight loss. She has ulcers along the buccal mucosa. Her abdomen is soft and nontender, and while she appears tired, the rest of the exam is normal. What is the patient’s diagnosis? 

em@3am

EM@3AM: Botulism

A 3-month-old female is brought into your ED by her mother for constipation and decreased PO intake for 3 days. She was born full term without complications and is breastfed along with some soft foods. When asking about changes in diet, her mother states they only eat organic and grow most of their ...

em@3am

EM@3AM: Penile Fracture

A 32-year-old male presents to the ED with penile pain. He states he was having sexual intercourse when he heard a loud pop, followed by sharp pain and immediate loss of erection. His vitals are HR 107, BP 128/46, RR 19, and T 37.2C. What is your diagnosis, and what diagnostic study would you order if there was blood at the meatus?