Atraumatic Spleen rupture Chief Complaint: Abdominal Pain HPI 41-year-old male presents to the emergency department with reports of the same exact abdominal pain as prior episodes of pancreatitis described as beginning last night, progressively worsening, 10 out of 10, epigastric, sharp, and stabbing. It is the same as pancreatitis pain he has had in the…
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high stakes Chief Complaint: Chest pain and shortness of breath HPI 37-year-old male reports about 36 hours ago he was on a bicycle riding approximately 20 miles an hour when he went over the handlebars and impaled his left shoulder with a tent pole that was planted into the ground. At that time, it went…
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a painful twist Chief Complaint Abdominal Pain HPI 47-year-old female presenting to the emergency department with approximately 2 hours of right upper quadrant pain described as sharp, constant, worse with movement, and associated with nausea. Patient self-induced emesis x1. She has never had this before. It did not change with 2 tablets of Tylenol at…
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Ludwig’s Angina Chief Complaint: Neck and jaw pain HPI: 32-year-old female with a history of IV drug use, last injected methamphetamine 2 days ago, presents for 1 day of right-sided neck and jaw pain with associated swelling. She denies trauma, dental pain and sore throat. She states the pain started around lunchtime yesterday and that…
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a hidden twist Chief Complaint Abdominal Pain HPI 5-year-old male presents to the emergency department for abdominal pain, which started this morning. Mother reports the pain woke the patient up from sleep. Reports the pain is crampy and patient has been crying since he woke up at 9:00. Mother reports she thinks this happened one…
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mr. freeze Chief Complaint: Painful wounds on skin for months HPI: 32-year-old male with past medical history of alcohol use disorder and general anxiety disorder presents with painful skin wounds to the right thigh for approximately four months. He curbed his cravings for EtOH with inhalant use. He uses keyboard duster cans several times a…
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stemi or stemi mimic? that is the question Chief Complaint: Chest Pain HPI 24-year-old male with no past medical history presents to the ER with left-sided chest pain since 7 AM. The pain started while he was riding his bike, reliably when his heart rate was above 130 on self-monitoring. He reports pain then radiated…
Read Moredon’t pick your brain Chief Complaint: Generalized Weakness HPI: 69-year-old male with a self-diagnosis of obsessive-compulsive disorder (OCD) presents to the ED via EMS for being “sick”. The patient reports he has not been able to get up so he has not eaten in 4 days. The patient reports he has not seen a doctor…
Read Morethe invisible bleed Chief Complaint: Hematemesis HPI: 43-year-old woman with a history of gastroparesis and seizures suddenly vomited blood about 4 hours prior to arrival to the ED. She has never vomited blood like this before. She describes copious hematemesis with clots. She has a history of esophagitis with mild hematemesis several years in the…
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COVId-19 vaccines Introduction COVID-19 has emerged to be the most challenging pandemic faced in the 21st century. With total cases as of April 2021 at about 147 million worldwide and 32 million in the US, this virus has demanded our attention since 2019. International efforts have shifted from limiting the spread of the virus to…
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