Today’s Morning Report is presented by Dr. Bart! Valproic Acid Background -Used for seizure disorders, BPD, migraine prophylaxis. -Peak concentrations at 6 hours except for enteric coated capsules. -Complications: -COMMON: Sedation, ataxia, weight gain, nausea, tremor, or hair loss -SEVERE: Hepatotoxicity, thrombocytopenia, aplastic anemia, pancreatitis, hyperammonemia (>80 ug/dL or Read more…
By Dr. Jacqueline Bober 4-year-old patient is BIB Grandma for not walking well. She states every time he tries to walk he cries. Physical Exam is noted for the rash below: References Kliegman RM, Stanton BF, et al. Nelson Textbook of Pediatrics. Read more…
By Yonatan Yohannes In July’s edition of ACEP Now, an article titled “Seven Best Practices to Reduce ED Misuse” discusses policies implemented in Washington State to reduce the overall cost of Emergency Department care. These policies were pioneered by the Washington state ACEP Chapter (go ACEP!) as well as Read more…
Here are the images again Both Drs. Greenstein and Chan got the answer right. Dr. Greenstein is the winner for putting in the read first. Please note that there is a fracture noted on the post reduction film. Answer: 1st Xray: read as inferior shoulder dislocation. 2nd Xray: Read more…
You’re kicking back in an empty CCT when you hear a ruckus in the hallway. In comes in a young man with a penetrating injury to the neck. He’s stridorous and diaphoretic on arrival. By Dr. Andrew Grock and Dr. Sally Bogoch Read more…
Here’s Dr. Alsup with today’s Morning Report! Tendon Rupture Background: -Galen described in 130-201 CE. In which he described a young man injured during a wrestling match -Young people: trauma/sports -40-60 yo: chronic inflammation Sx: pain, swelling, loss of assoc muscle function. – frequently is an immediate ‘pop’ or Read more…
I would like to thank Sally for presenting such a good paper on heat stroke this month at the wilderness medicine mini-fellowship meeting. If you would like to read that paper, it can be found here: heat stroke She was also nice enough to put together a summary if you Read more…
We know using skilled translators has many benefits such as improving patient outcomes, satisfaction, pain control, and number of medical errors (see sidebar below). In the United States, healthcare providers have increasingly been encountering patients who have limited English proficiency (LEP), with 15% of people reporting they spoke English “not Read more…
27 year old male presents to Janus General Hospital (where Drs. Grock and Freedman also happen to work) s/p left shoulder injury. The patient says he was playing basketball when the incident occurred. He states that he has been unable to “put down” his left arm since the injury. On Read more…
Truly excellent interpretation by Dr. Joey Freedman. This is indeed a patient with rapid atrial fibrillation with aberrantly conducted complexes and intermittent biventricular pacing. Whew! Think of atrial fibrillation with rapid ventricular response, but the ventricles are unable to respond quickly, so the rhythm appears wide and similar to ventricular Read more…