At wards 101 we talked about a 50 year old female with scleroderma, pulmonary HTN, OSA and T2DM who presented to the ED with progressive SOB and new onset chest pain. She described the pain as substernal, squeezing/pressure and unrelieved with rest. EKG showed sinus tachycardia and her bedside ECHO was without gross abnormalities. Troponin … Continue reading Shot through the heart. Wards 101 1.18.2019
Category: Wards 101
It’s a syndrome. Wards 101 1.10.2019
At wards 101 two patients were discussed with concern for Mirizzi syndrome. Remember this is when you get common hepatic duct obstruction due to external compression or impacted stone in the cystic duct vs Hartmann's pouch. It can present exactly like acute cholecystitis or ascending cholangitis but intervention often leads to laprascopic injury to the … Continue reading It’s a syndrome. Wards 101 1.10.2019
Too much alcohol? Wards 101 1.9.2019
At wards 101 we discussed a case of a 44 year old male who underwent alcohol withdrawal (estimated 30 cans of beer per day) at an outside hospital of 3 days duration and then was brought back to the hospital for continued altered mental status and a fall. Prior history included seizures with alcohol withdrawal … Continue reading Too much alcohol? Wards 101 1.9.2019
Not just another virus. Wards 101 1.8.2019
We talked about a 50 year old female with T1DM presenting with 3 days of refractory n/v and diarrhea. Initial BMP concerning for Na+ of 112, K+ of 4, mild acidosis with gap of 15 and glucose of 230. Beta-hydroxybutyrate not initially checked. Remember, in patients with T1DM DKA can occur at lower glucose levels than … Continue reading Not just another virus. Wards 101 1.8.2019
Head and gut. Wards 101 1.3.2019
At wards 101 we discussed a case of a 45 year old male with history of diabetes, osteomyelitis and non-functioning carcinoid tumor s/p right hemicolectomy (unknown more details) who presented with 1 month of worsening abdominal pain, diarrhea and headaches. . Remember that secretory diarrhea typically do not resolve at night nor do they improve … Continue reading Head and gut. Wards 101 1.3.2019
