Category Name: em@3am

em@3am

EM@3AM: Abdominal Aortic Aneurysm

A 72-year-old male presents with left-sided flank pain for the last two weeks that has worsened over the past several hours. He also feels lightheaded when standing today. He is tachycardic to 124 beats per minute and hypotensive to 117/84 mm Hg relative to his chart baseline which has an average sy...

em@3am

EM@3AM: Polyarteritis Nodosa

A 59-year-old male presents to the ED with abdominal pain, hematuria, and rectal bleeding for the 5 days. His symptoms have been associated with unintentional weight loss, intermittent fevers, skin rash, and fatigue over the past 3 months. He has a past history of hepatitis B, hypertension, diabetes...

em@3am

EM@3AM: Testicular Torsion

A 25-year-old male is brought to the ED by EMS after sudden onset right testicular pain. He denies any trauma or contact to his scrotum or perineum; however, he endorses severe, sudden pain associated with nausea and non-bloody, non-bilious emesis. He additionally complains of mild lower right abdom...

em@3am

EM@3AM: Impetigo

A 9-month-old male presents with a rash and fever for 4 days. Mom reports the rash began in the axillae and groin and spread to the trunk. She notes the rash started as small, erythematous lesions that have progressed to bullae which are unroofing. The rash is associated with intermittent fevers (Tm...

em@3am

EM@3AM: Sacral fractures

A 75-year-old male with a history of hypertension, osteoarthritis, and diabetes mellitus presents to the ED with a chief complaint of lower back pain.  He states that he fell a few days ago and the pain is getting worse, particularly when he is sitting down. His vitals include blood pressure 150/95...

em@3am

EM@3AM: Aortic Stenosis

An 83-year-old female presents to the ED with dyspnea at rest following a syncopal episode. Patient reports she was out for a walk with her husband when she began to feel lightheaded, short of breath, and then fainted. Triage vitals include BP 88/50, HR 115, RR 24, O2 98%. ECG is without signs of ac...

em@3am

EM@3AM: Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

A 55-year-old male presents to the ED for a rash of 2-day duration. He had URI symptoms for 4 days preceding the rash with myalgias and subjective fevers. He notes the rash began as small painless, erythematous papules but has progressed to larger, tender bullae. The rash began on his trunk and has ...

em@3am

EM@3AM: Bacterial Meningitis

A 21-year-old male is brought to the ED via EMS after a reported seizure. As per girlfriend, the patient began complaining of a headache yesterday, and today he is confused. He is febrile and tachycardic. He is confused and has nuchal rigidity. However, Kernig and Brudzinki signs are negative. CT is negative. What is most likely diagnosis, and what is the next step in diagnosis?