A 42-year-old male undergoing recent radiation therapy for colorectal cancer presents with pelvic and anal pain and pain with defecation. He experiences extreme pain prior to and during defecation. He has had mucous and blood in his stool. He denies a history of hemorrhoids. Pertinent physical exami...
A 70-year-old male with diabetes, coronary artery disease, and one-vessel CABG presents with palpitations and angina for one day. He is in no acute distress. His vital signs include BP 148/96, HR 150, RR 18, SpO2 96%, and T 37.2C. His EKG reveals atrial flutter.
A 66-year-old male presents via EMS in respiratory distress. For the past several days he has had worsening productive cough, chest pain, dyspnea, and fever. He appears fatigued, is sitting up in bed, and has increased work of breathing. On exam there is no JVD, 1+ edema, and crackles bilaterally. V...
A 62-year-old male presents with abdominal pain and fever for 2 days. He has recently completed induction chemotherapy a few days prior. Review of systems is remarkable for vomiting and anorexia. Exam reveals BP 96/69 mm Hg, HR 122, T 101.9 oral, RR 28, SpO2 97% on room air. He is ill appearing and ...
A 24-year-old female presented to the ED for pelvic pain that started 8 hours ago. The patient reports sudden onset pain that is getting progressively worse, along with vaginal bleeding. The patient has not had unprotected sex and no history of sexually transmitted infections. She appears visibly u...
A 32-year-old female with a previous medical history of acne on isotretinoin presents to the ED for 2 months of headaches that awake her from sleep, more prominent in the morning. She also endorses nausea and vision changes. She notes that her vision is blurry especially in her periphery. The pati...
A previously healthy 2-year-old boy presents with 3 days of recurrent nosebleeds. He had no adverse birth history and is up to date on his vaccinations. The patient’s mother denies any known trauma and the patient denies picking his nose. In addition, he has no fever, headaches, nausea, hematuria,...
A 4-year-old vaccinated male is brought to the ED by his parents for 3 days of hematuria and abdominal pain. They present now because he refuses to ambulate. He has a rash on his legs that family attributes to playing outside in the grass. His vital signs include HR 135, RR 20, and temperature of 37...
