FOAMed

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EM@3AM: Systemic Lupus Erythematosus

A 23-year-old female presents to the ED with slurred speech, left lower leg weakness, and confusion. A friend is with her and states that the patient does not take any medications, has no past medical history, but has been complaining of various symptoms over the past year.
On exam, the patient has 0/5 strength in her left lower extremity, has slurred speech, and is unable to answer most of your questions. You code stroke the patient. CT head/CTA head and neck are unremarkable, but MRI brain reveals stroke.

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EM@3AM: Inflammatory Bowel Disease

A 24-year-old male with no past medical history presents with several days of oral ulcers and throat pain. He also notes multiple months of diarrhea and hematochezia. He has lost roughly 30 lbs over the preceding 6 months. He has normal vital signs but appears malnourished, with a weight of 48 kg. He has dry oral mucous membranes, abdomen is diffusely tender, and he has ulcers on the uvula and soft palate. Labs reveal anemia, leukocytosis, electrolyte abnormalities, and elevated inflammatory markers. What is the diagnosis?

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