Key ligaments
Fracture Classification - Young-Burgess
Pelvic ring injuries
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Acute Otitis Externa
Cerumen Impaction Options
Foreign Body Removal
Acute Otitis Media
Acquired Long QT
Bad Trauma Airway (Cricothyroidotomy, Traumatic Brain Injury
Occult Hip Fracture
Basics
Some Concerning History?
Migraine
Consider Imaging for:
Treatments for benign HA
CASE 1 - Pupura, Diffuse Lymphadenopathy, Fatigue, Arthralgia, 20lb weight Loss. DDx: HUGE and includes: HIV/AIDs, syphilis, tick borne disease, endocarditis, meningococcemia, thrombocytopenia Core Concept: LUPUS
CASE 2 - 55yo with n/v/d after eating fast food. Hx of previous CVA, TIAs, and Mitral Valve Repair. Is this Acute Gastroenteritis? Nope - Imaging: right vertebral artery occlusion with posterior CVA. Core Concepts: Posterior CVA
CASE 3 - Teenager with complains of persistent shoulder pain, Normal x-rays, Tachycardic. Later found to have Hypoxia!
Initially he looked well... then he didn't. Found to have CA-MRSA subperiosteal abscess. Core Concepts - CA-MRSA
Lip and facial swelling - Angioedema to the Max!
Our New Scope is found in Room 1 of pixis- "endoscopy storz'. Attached to cmac to black plug, 29 yo bilateral leg pain Lactic acidosis
1. Resusucitate/supportive care 2. Identify cause with appropriate lab ordering 3. Empirically give Thiamine 500mg IV 4. Consider empiric Fomepizole after tox consult 5. Sodium Bicarbonate is controversial 6. When in doubt, call nephrology and dialyze Alcoholic KetoAcidosis -- Heavy etoh use with a recent binge, sudden cessation with abd pain, N/V. GI symptoms seen in 80%. -- Present with Absent ETOH level and Anion Gap metabolic acidosis. -- Due to increased betahydroxybutyrate ketone body, UA does not pick up ketone bodies on dip. -- Rarely will see severe lactic acidosis and if present think sepsis, seizures or thiamine deficiency. Tx:
Thiamine deficiency Pyruvate cannot enter TCA cycle causing high lactic acidosis resulting in Dry (neurologic) and Wet (cardiac) Beriberi. Also causes Wernicke (triad of AMS, opthalmoplegia, and ataxia seen only in 10% of patients). At risk- etoh, iatrogenic, aids, malignancy, gastric bypass, TPN 44yo fall from standing
Conjunctivitis: Allergic, viral, bacteria
Uveitis: inflammation of iris, ciliary body, choroid
Acute closed angle glaucoma: emergency need to make dx, can have visual loss.
Back Pain
Indeterminate Ultrasound
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