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A 7-year-old male recently arrived from the Democratic Republic of Congo presents for a "wellness check" from a resettlement agency. No U.S. medical records. His mother reports fatigue, poor appetite, and one episode of bloody stool. Vaccinations are unverified. On exam he is pale and has a mildly distended abdomen and scattered excoriated papules on trunk and extremities. What is on your differential? What makes the differential and workup for this patient different than the average pediatric patient?

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How should you manage chloramphenicol toxicity?
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Dr. Tannenbaum covers a case of baclofen toxicity in today's ECG Pointers.
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Acute heart failure exacerbation disposition

Not all patients require admission

 

Consider patient hemodynamics, respiratory status, ECG, labs (Cr, troponin, sodium/electrolytes), ability to ambulate, follow up

 

Elevated troponin and serum Cr associated with worse outcomes

 

Don’t use risk tools alone for DC, but Ottawa Heart Failure Risk Scale may assist in admission (ACEP Level B)

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