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Page 3 of 65
Page 3 of 65
Page 3 of 65
A Case Report of an Unstable C-spine Fracture in the Emergency Department
DOI: https://doi.org/10.21980/J8SK90The initial workup in the ED showed an acute displaced fracture of the left occipital condyle (CT-coronal, fracture of the left occipital condyle, red arrow; displacement, orange line), a shattered left lateral mass with involvement of the vertebral canal (CT-axial, red arrow), and malalignment of the craniocervical junction (CT-sagittal, red outline). The CT angiogram head and neck showed a possible irregularity in the left vertebral artery. The CT head without contrast had no significant findings.
Eye-Opener: A Case Report of Eyelid Taping as Presenting Symptom of Myasthenia Gravis
DOI: https://doi.org/10.21980/J8NW8GPhysical exam was significant for a very pleasant, well-appearing female in no acute distress, noted to have clear plastic tape attached to her bilateral eyelids and brows (Image 1). When the tape was removed, she had bilateral ptosis, more significantly in the left eye (Image 2). She had no conjunctival injection or pallor. Her airway was patent and protected. She had no neck masses or carotid bruits. Her heart and lung exams were normal, with no evident respiratory distress. Her neurologic exam was further significant for limited extra-ocular movement (EOM). Her most notable deficits were with lateral and upward gaze (Video 1) indicative of weakness at the muscles innervated by cranial nerves III and VI. Her pupillary response was symmetric and brisk bilaterally. She had no additional cranial nerve deficits, slurred speech, or asymmetry in her strength or sensation throughout.
A Case Report of Inferior Rectus Abscess
DOI: https://doi.org/10.21980/J8J35GNon-contrast computed tomography (CT) imaging of the head in coronal, sagittal, and axial planes revealed a distinct 1.7 x 2.2 x 1.4 cm peripherally enhancing fluid collection within the left inferior orbit, involving the inferior rectus (yellow circle). This lesion resulted in restricted extraocular motility due to structural compression of the left globe. Laboratory results showed a mildly elevated white blood cell count of 11.5/mm3 and otherwise normal results including C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR).
A Case Report of Hydropic Gallbladder Presenting as Right Lower Quadrant Abdominal Pain
DOI: https://doi.org/10.21980/J8DD26Computed tomography (CT) of the abdomen and pelvis with contrast was ordered, and general surgery was consulted for the initial working diagnosis of acute appendicitis. However, the CT scan resulted with findings of a markedly distended gallbladder measuring approximately 14.5 x 4 centimeters (cm) with marked gallbladder wall thickening (magenta) and pericholecystic fat stranding (cyan). The appendix was not dilated and had no inflammatory changes or edema. Follow-up right upper quadrant ultrasound confirmed the diagnosis of acute cholecystitis.
Do’s and Don’ts of Taking Care of Deaf Patients
DOI: https://doi.org/10.21980/J8336TBy the end of this didactic, the learner will demonstrate increased comfort with communication with DHH patients via improved awareness of communication pitfalls and through approaches to communicating with DHH patients in a limited capacity, such as without timely access to interpreters or in an environment where staff are unfamiliar with DHH patients. An in-depth assessment of cultural awareness and description of proper communication techniques, necessary equipment, or interpreter working relationships is beyond the scope of this project.
Medical Simulation Anywhere and Anytime: Simulation in a Backpack
DOI: https://doi.org/10.21980/J8Z94WBy the end of this simulation experience learners will be able to: 1) Recognize and manage emergencies through immersive simulation experiences with an inflatable manikin and pre-programmed free software system; 2) demonstrate knowledge and skills to resuscitate patients with medical emergencies; 3) enhance confidence and competence in responding to medical emergencies using portable, low-tech resources; and 4) foster interdisciplinary collaboration and effective communication during scenarios.
Alcohol Withdrawal
DOI: https://doi.org/10.21980/J87S8QAt the end of this oral boards session, learners will: 1) demonstrate the ability to perform a detailed history and physical examination in a patient presenting with signs and symptoms of alcohol withdrawal, 2) investigate the broad differential diagnoses, including electrolyte abnormalities, trauma in the intoxicated patient, mild alcohol withdrawal, and delirium tremens, 3) list appropriate laboratory and imaging studies to include complete blood count (CBC), complete metabolic panel (CMP), magnesium level, computed tomography (CT) scan of the brain; 4) understand the management of hypoglycemia with concurrent administration of thiamine to prevent Wernicke’s encephalopathy and subsequent Korsakoff syndrome, 5) appropriately treat acute alcohol withdrawal with intravenous (IV) hydration and benzodiazepines, phenobarbital, or alternative medications, and 6) understanding the need for the complex management of these patients, appropriately disposition the patient to the intensive care unit after consulting with critical care specialists.
Acetaminophen Toxicity
DOI: https://doi.org/10.21980/J8435RAt the end of this practice oral board session, examinees will be able to: 1) demonstrate an ability to obtain a complete medical history in an oral boards structured interview format, 2) review appropriate laboratory tests and imaging to evaluate abdominal pain, 3) investigate a broad differential diagnosis for right upper quadrant abdominal pain, 4) recognize chronic acetaminophen toxicity, 5) initiate the appropriate treatment for chronic acetaminophen toxicity, 6) demonstrate effective communication with the patient, consultants, and the admitting team.
Journal Court: A Novel Approach to Incorporate Medicolegal Education into an Emergency Medicine Journal Club
DOI: https://doi.org/10.21980/J8093TBy the end of this exercise, participants should: 1) identify the four necessary elements for a malpractice claim, 2) understand the basic structure of medical malpractice litigation, and 3) critically analyze medical literature representing diverging viewpoints or conclusions.
A Cold Case: Myxedema Coma
DOI: https://doi.org/10.21980/J8VM0JAt the conclusion of the simulation, the learner is expected to: 1) Recognize the key features on history and examination of a patient presenting in myxedema coma and initiate the appropriate workup and treatment, 2) Describe clinical features and management for a patient with myxedema coma, 3) Develop a differential diagnosis for a critically ill patient with altered mental status, 4) Discuss the management of myxedema coma in the ED, including treatments, appropriate consultation, and disposition.