What should you do?

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What should you do?

A 54 y/o M with pmh of smoking and htn presents to the ED for evaluation of intermittent chest pain that has worsened over the last few days, occasionally occurring at rest.  Currently the patient is asymptomatic and has no complaints.  Please review the patient's EKG (prior email).  A troponin was drawn and is negative, all other labs are wnl.  The patient currently wants to go home.  

Is the patient's EKG suggestive of any particular condition or concern?  What should you do?

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Identify the Disorder

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Identify the Disorder

A 19 y/o M was playing baseball and was accidentally hit in the eye with the ball.  The patient is reporting eye pain and slightly blurred vision.  On inspection in the ED his vision is 20/20 bilaterally, however this physical exam abnormality is appreciated.

Please identify the disorder seen in the attached picture.  What genetic disorder, seen with higher prevalence in African-Americans, would increase the risk of developing ischemic complications of the retina and optic nerve?  

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Name the Abnormality

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Name the Abnormality

A 45 y/o F with a pmh of gastric bypass surgery presents to the ED for evaluation of copious diarrhea x 3 days.  The patient appears weak, dehydrated, and sluggish.  During your ED evaluation the patient has an acute onset tonic-colonic seizure.  The patient is given ativan and is stabilized.  Finger stick is 98mg/dL, labs are drawn, results pending.  The patient then proceeds to have another seizure.  

What electrolyte abnormality could have contributed to the patient’s epileptic event? 

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What Should You Do?

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What Should You Do?

42 y/o M is bibems for AMS.  The patient has signs of head trauma and will likely need a HCT.  The patient becomes lethargic, shows signs of respiratory distress and is safely intubated via RSI with pretreatment.  Tube placement is confirmed via ETCO2.  Although sick, the patients vs are normal.  The patient is tx to radiology where the HCT is negative for acute pathology.  Upon return to the ED, the patient begins to desaturate and becomes hemodynamically unstable. 

What should you do?  If the patient was an asthmatic, what should be your first action?

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