Category Name: em@3am

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?

em@3am

EM@3AM: Laryngospasm

An 8-year-old male presents after falling onto an outstretched hand. He has an obvious dinner fork deformity to the right forearm. X-ray confirms a fracture of the distal radius and ulna. You prepare for procedural sedation with ketamine while you reduce and splint the fracture. You run through the ...

em@3am

EM@3AM: Nephrotic Syndrome

A 25-year-old female with no significant past medical history presents with progressive periorbital and lower extremity edema for one week. She denies recent fever, chest pain, shortness of breath, allergies, or recent travel. Vitals include BP 120/90, HR 90, RR 18, Temp 98.7F. Exam shows a developm...

em@3am

EM@3AM: Beverage Tab Ingestion

A 12-year-old boy with no past medical history accidentally ingested a soda can tab 2.5 hours prior to arrival. He is asymptomatic at present, feels well, and is able to tolerate secretions without difficulty. On exam, the patient is alert, acyanotic, and non-stridulous. Breath sounds are clear to a...

em@3am

EM@3AM: Peritoneal Dialysis Emergencies

A 42 year-old male presents with abdominal pain and fevers for 72 hours, with nausea and vomiting for 24 hours. He has a history of ESRD and has been on peritoneal dialysis for 5 years. Triage vital signs (VS): BP 105/60, HR 121, T 101.4 temporal, RR 24, SpO2 98% on room air. Pertinent physical exa...