In the ED, their vitals/exam are as above. Patient with irregular narrow complex tachycardia on monitor/EKG suggestive of AFib vs. AFlutter (more likely AFlutter given ventricular rate is 150 and there is a sawtooth pattern). No evidence of >3 p-wave morphologies to suggest MAT requiring search for underlying lung disease. Unclear underlying etiology of patients […]

In the ED, their vitals/exam are as above. Differential includes asthma exacerbation, PNA, viral URI. Lower suspicion for PE as patient without pleuritic CP or LE signs of DVT including no edema/unilateral swelling/calf pain. Lower suspicion for primary cardiac etiology given EKG and lack of hypervolemia on exam. No history to suggest foreign body aspiration. […]

In the ED, their vitals/exam are significant for tachycardia, increased respiratory effort and rate, inspiratory and expiratory wheezes heard throughout, and diminished sounds at the apices bilaterally. Differential includes asthma exacerbation, PNA, viral URI. Lower suspicion for PE as patient without pleuritic CP or LE signs of DVT including no edema/unilateral swelling/calf pain. Lower suspicion […]

In the ED, their vitals/exam are significant for tachycardia, increased respiratory effort and rate, inspiratory and expiratory wheezes heard throughout, and diminished sounds at the apices bilaterally. Differential includes asthma exacerbation, PNA, viral URI. Lower suspicion for PE as patient without pleuritic CP or LE signs of DVT including no edema/unilateral swelling/calf pain. Lower suspicion […]

In the ED, their vitals/exam are significant for tachycardia, increased respiratory effort and rate, inspiratory and expiratory wheezes heard throughout, and diminished sounds at the apices bilaterally. Concern for status asthmaticus with possible triggers including PNA, viral URI, and allergic reaction. Lower suspicion for PE as patient without pleuritic CP or LE signs of DVT […]

On my assessment, this patient’s presentation is most consistent with ***.

In the ED, their vitals/exam are as above Differential includes cirrhosis, alcoholic hepatitis, congestive hepatopathy from CHF, Budd-Chiari, portal venous thrombosis, idiopathic portal fibrosis, malignancy, peritoneal TB, pancreatitis, serositis, intravascular volume depletion from LVP, SBP, sepsis, and nephrotic syndrome. Lower suspicion for non-hepatic, localized abdominal pathology given lack of acute distress/focal abdominal TTP. No current […]

In the ED, their vitals/exam are as above. Patient’s symptoms are likely MSK in origin. However, given patient’s age/history/persistent arm symptoms, unstable aortic aneurysm/dissection is on differential, as is ACS with this left symptoms being the patient’s anginal equivalent. Upper extremity is warm and well-perfused with 2+ radial pulse making acute limb ischemia less likely. No neck tenderness […]

In the ED, their vitals/exam are as above. Differential includes continue phlebitis, DVT, bicep strain/tear/rupture, bicep tendon strain/tear/rupture, referred/neuropathic pain, distal humerus/proximal radial/ulnar bruise/fracture. Lower suspicion for cellulitis, necrotizing fascitis given pain is not out of proportion to exam, compartment syndrome given lack of pallor/paresthesias/paralysis/abnormal pulse, or elbow/shoulder bruise/fracture/dislocation given lack of TTP in that […]

In the ED, their vitals/exam are above. Patient with hypoxemic respiratory failure in the setting of ***. – Labs/Tests: VBG plus, Lactate, CBC, CMP, Lipase, Trops x2, BNP, Procalcitonin, PT/INR, BCxs, UA w/ reflex UCx, SCx, COVID-19 RT PCR, Influenza A/B, RSV, Urine Strep pneumo and Legionella. Low threshold for COVID risk stratification labs if […]