Case 41: Abdominal Aortic Aneurysm
Skyler Sloane, Benjamin Supat An 83-year-old man presented to the emergency department with a chief complaint of acute onset lower abdominal pain radiating to the right groin. The patient reported a history of hypertension, coronary artery disease, and nephrolithiasis. Vitals: BP 71/51 | Pulse 84 | Temp 98.0 °F (36.6 °C) | Resp 20 | SpO2 99% on RA On physical exam, the patient appeared to be in obvious discomfort. There was diffuse abdominal tenderness though no rebound or guarding was observed. A bedside FAST exam was performed. What do you see? ...Case 40: Rare Ocular Condition Diagnosed by Point-of-Care Ultrasound
Skyler Sloane & Andre Velazquez A 73-year-old male presented to our emergency department with a chief complaint of new intermittent double vision for the past two weeks. The patient noticed that he saw double when looking at signs on the freeway. These were new symptoms he had not experienced in the past. The patient reported a history of hypertension, hyperlipidemia, and recently diagnosed prostate cancer. The patient also confirmed a history of ocular migraine. The patient denied current headaches, new floaters or flashes, curtains, or clouds in his vision. Upon arrival, vital sign...Case 39: Superficial Thrombophlebitis
Aastha Shah A 57-year-old male with a past medical history of HIV, hyperlipidemia (on a statin), chronic obstructive pulmonary disease (COPD), lumbar stenosis, and chronic diastolic heart failure presented with a chief complaint of pain and swelling in the right inguinal region for the past 3 days. The patient reported a similar presentation in the past, during which he was told that he had a hernia. He denies associated symptoms such as fever, chills, nausea, vomiting, abdominal distention, constipation, or urinary changes. He passed stool normally this morning and has no history of prior ...Case 38: Painless Worsening Vision
Liz Volochyna-Farber A 37-year-old male with a past medical history of retinal detachment (RD) of the left eye (OS), left eye cataract surgery and retinal tear in the rigth eye (OD) s/p laser presents to Emergency Department (ED) on a Sunday with painless worsening right eye vision. It started with a floater in the eye 2 days prior. The patient went to an outside ED, has been given a diagnosis and was told to see ophthalmology, but was unable to do that over the weekend. Meanwhile his symptoms worsened, so he came to our ED. He endorsed mild itching to the eye but denied trauma, pain, forei...Case 37: Forearm Fracture
Teini Elisara Case An 82 year old female with a past medical history of anemia of chronic disease, breast cancer, diabetes mellitus, hypertension, osteoporosis, rectal adenocarcinoma, scleroderma with pulmonary involvement, and systemic lupus erythematosus presented to the emergency department after a mechanical fall the night prior. Patient reported that she was getting into bed when she tripped and fell on the left side of her body landing on her left arm and hit in the side of her head on the floor. Patient endorsed severe pain to her left wrist. She was able to move her fingers; howe...Case 36: Retained Shrapnel
Grace Feng Case: A 59-year-old male presented with a chief complaint of retained bullet in his abdomen. He reported a past medical history of multiple gunshot wounds in 2017 and had an exploratory laparotomy related to those injuries. He was uncertain why the bullet was not initially removed, but reported the wound site was stable until several days ago, when it began leaking serous fluid. He denied fevers, chills, and purulent discharge or pain at the wound site. Vitals: BP 112/72 | HR 72 | Temp 98.4 ºF (36.9 ºC) | Resp 16 | SpO2 98% on RA On physical examination of the abdomen, it...Case 35: Intracardiac Mass
Charlotte Ellberg, MD History:61-year-old man with a history of asthma, colon cancer s/p hemicolectomy (on Xeloda), COPD, presenting with chief complaint of abdominal pain, non-exertional chest pain, and dyspnea. He denied fever, chills, cough, nausea, vomiting, diarrhea, or dysuria. He was recently hospitalized at an outside hospital for pancreatitis and ascending cholangitis and was treated with antibiotics and underwent an ERCP. He reported that he had completed the antibiotics and was taking rivaroxaban after being told he had a blood clot in his heart. He opted for a patient-directed d...Case 34: Rare Cause of Knee Pain
A 58-year-old female presented with a chief complaint of focal lateral knee pain and swelling. She had a remote history of anterior cruciate ligament repair, as well as medial collateral ligament injury and meniscal injuries. The patient stated that she had a history of recurrent intermittent effusions. However, that day she noted focal swelling. She reported playing tennis a few days before and noted a pain in her knee with pivoting. No knee instability. No fever. Vitals: BP 118/60 | Pulse 52 | Temp 97.8 °F (36.6 °C) | Resp 12 On physical examination of the knee, ...January Update
We're building out our new comprehensive Bedside Ultrasound Manual. Check it out here. New chapters added regularly!Rapid Fire Ultrasound: Introduction to the Mindray TE X
In the first video of our TE X instructional series, Zac Fica, MD, MS, walks us through the basic features and functionality of our new Mindray machine.