Management

SOB + Fever

PNA vs. Viral URI vs. Influenza likely given pts recent fever and generalized malaise Angina less likely given lack of CP however given pts HLD and HTN plan trop x1 CHF less likely given lack of LE Edema/DOE/chest pain. Defer troponin/bnp PE given lack of shortness of breath Wells low risk Less likely PTX given […]

IUD Pain

Pelvic pain after IUD placement. DDX includes IUD uterine disruption vs. Ovarian torsion. Plan cbc, bmp, type and cross, PT-INR for evaluatin for RH status, Transvaginal US to evaluate for uterine rupture vs. Ovarian torsion

APEpistaxisposterior

Patient today with epistaxis. Without concern for septal hematoma, anterior source of bleed. Without s/s of secondary facial fractures. Without septal necrosis. Plan packing with TXA given slow likely venous bleed and CBC for evaluation of HCT drop.

Croup

Likely croup vs. URI. less likely bacterial tracheitis, epiglottitis, foreign body aspiration, peritonsillar abscess, retropharyngeal abscess, and angioedema Plan Dex x1 0.6mg/kg. Without need for racemic epi given mild nature of disease without focal respiratory distress