In the ED, their vitals/exam are as above. Patient’s Alvarado score is *** prior to labs, however with findings consistent with appendicitis on exam. Without concern for ovarian torsion. Less likely UTI vs. cystitis. Less likely pyelo. – Labs/Tests: EKG, D-stick, CBC, CMP, lipase, coags, UA, Upeg, urine culture – Imaging: BSUS (start just above […]

In the ED, their vitals/exam are as above. Patient with the sensation of pulsations (also felt externally) in her upper belly while at work. Differential for the symptoms includes new aortic process (albeit unlikely given patient without significant current symptoms or risk factors), increased awareness of her aortic pulsations without frank dangerous process, bowel gas, esophageal spasm with referred pain […]

In the ED, their vitals/exam are as above. Concern for {Blank single:19197:: “aortic dissection +/- intramural hematoma “,”symptomatic AAA +/- rupture”} given patient’s abrupt onset {Aortic Dissection:41855} especially considering history of {Risk factors for aortic dissecion/AAA:48153}. Differential diagnosis is broad but includes aortitis (with potential etiologies including giant cell arteritis, takayasu arteritis, syphilis, mycobacterium, neoplasia), […]

In the ED, their vitals/exam are as above. Suspect nausea and vomiting is related to recent antibiotic initiation. Suspect that chills are in the setting of undertreated UTI/cystitis. No flank/CVA tenderness to suggest pyelonephritis. Negative pregnancy testing yesterday. No vaginal discharge to suggest vaginitis or cervicitis or PID. Lower suspicion for kidney stone, focal abdominal or […]

In the ED, their vitals/exam are as above. Ddx includes sprain, bruise, dislocation, fracture. Lower suspicion for concern for DVT given trauma and lack of risk factors. No concern for osteo vs. cellulitis on exam today. – Labs/Tests: None – Imaging: XRs of *** tib-fib/ankle/foot – Treatments: Motrin, Tylenol, Lidocaine patch – Consults: None. Ortho […]

In the ED, their vitals/exam are as above. The etiology of this patient’s angioedema is likely ACE-inhibitor/ARB mediated but other bradykinin-mediated (hereditary) angioedema and histamine-induced angioedema are on the differential. With*** current imminent airway compromise as patient with*** stridor, with*** tachypnea, and with*** change in O2 saturation. Hence, will proceed as below. – Labs/Tests: CBC, […]

In the ED, their vitals/exam are as above.The etiology of this patient’s angioedema is likely ACE-inhibitor/ARB mediated but other bradykinin-mediated (hereditary) angioedema and histamine-induced angioedema are on the differential. Without current imminent airway compromise as patient without stridor, without tachypnea, and without change in O2 saturation. Without evidence of imminent airway compromise as patient is […]

In the ED, their vitals/exam are as above. Patient with H/H drop from *** to *** in the setting of ***. The differential for anemia is classically divided into two categories: underproduction of RBCs (RI 2%). Underproduction is further divided into three categories based on MCV: MCV 100 is macrocytic (B12 deficiency, folate deficiency, liver […]

In the ED, their vitals/exam are as above.  Patient with anal fissure on exam.  No concern for significant GI bleed.  No concern for abscess or deeper infection.  – Labs/Tests: None – Imaging: None – Treatments: Consider injection of fissure with 1% lidocaine with epinephrine, consider figure-of-eight stitch if patient is still bleeding after injection – Consults: None – Dispo: Likely discharge with […]

In the ED, their vitals/exam are as above. Most likely prolonged postictal state versus nonconvulsive seizures. Ddx also includes infection, such as UTI, PNA. May be due to intercranial process. May be due to a cardiopulmonary process. May be due to electrolyte abnormalities such as hypoglycemia, hyperglycemia, hyponatremia, hypernatremia, hypokalemia, uremia. May be due to […]