Thanks to Dr. Grock for presenting today’s Morning Report! The Sign Out 45 yo M h/o AIDS (CD4=8, not on HAART) presents with voluminous non-bloody diarrhea x 3 days and near syncope/light-headedness today. No recent travel/antibiotics. He reports trying to drink a lot of fluid, but is a little nauseous, Read more…
That moment when an idea strikes you. Something stutters the laminar flow of the mind. A mental murmur, perhaps. It’s that hiccup that alerts you that something’s up, something needs to be reassessed. This happened to me at Janus General, where Grock works. Neurology clinic referred a patient to Read more…
Thanks to Dr. Ting for today’s Morning Report! Chronic SCI Complications of chronic SCI – DVT/PE – Decubitus ulcers – Pneumonia (even down to thoracic levels although only C3-5 controls the diaphragm due to impaired cough reflex) – Increased prevalence of CAD – UTI/renal stones due to bladder Read more…
EM-CCM Conference: January 2014 Presented by Dr. LoCascio Summary by Dr. Grock The Case: 67 yo F pmhx ESRD on HD, HTN with slurred speech and Left sided weakness starting at 19:30. H&P and work-up significant for BP 208/95, R gaze preference, L facial droop, decreased strength to LUE/LLE. Read more…
In the evaluation of SAH in the ED, does everyone with a negative head CT require subsequent LP? On 1/29/14!, we’ll review Perry’s study in BMJ on CT performed within 6 hours of headache onset. Practice-changing? Peruse and decide. Enjoy! and please post your thoughts, comments and questions below. http://www.bmj.com.newproxy.downstate.edu/content/343/bmj.d4277?view=long&pmid=21768192 Read more…
Here’s Dr. DiMare with today’s Morning Report! Post Traumatic Seizure (PTS) Seizure after mild to moderate trauma: – 1.5 to 15% of patients – Are due to focal, structural changes as a result of injury – “Early” – occurring within 1 week of event, but generally not within Read more…
Today’s Morning Report is presented by Dr. Brown! Recommendations for Management of First-time Seizure and Status Epilepticus 1. Are we mandated to report to DMV? – no, but other states (CA, DE, NV, NJ, PA) have mandatory reporting laws. 2. Which AED’s can you measure blood levels? – Read more…
Thanks to Dr. Bradby for today’s Morning Report! Stroke in Sickle Cell Disease Neurological and Hematological Emergency 24% of sickle cell disease patients have a stroke by the age of 45 years these people have an increased risk of secondary stroke 2-3 years after initial CVA (recurrence rate of Read more…
Here’s Dr. Adal with today’s Morning Report! Differential diagnosis for generalized weakness Neuromuscular (UMN and LMN) Amyotrophic Lateral Sclerosis: Degeneration of the motor neuron Botulism: Toxin prevents release of Ach at neuromuscular junction Ciguatoxin: Toxin causes cell membrane excitability and instability Cord compression Cord infarction CVA: Ischemic Read more…
Here’s Dr. Kong with today’s Morning Report! HiNTS exam What is the HiNTS exam? A set of 3 tests used to specifically differentiate central from peripheral etiology in setting of acute vestibular syndrome/ AVS (rapid onset (seconds to hours) of vertigo, nausea/vomiting and gait unsteadiness with head-motion intolerance and Read more…