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Hyphema Patient with a history of blunt or penetrating trauma Complaining of blurry vision PE will show unequal pupils, injected conjunctiva/sclera and blood in anterior chamber Treatment is eye protection and rest with the head of the bed at 30-45 degrees all the times A 13-year-old boy is brought to the urgent care clinic by his mother. He […]
Meniere Disease Patient will be complaining of episodic low-frequency hearing loss, tinnitus with aural (ear) fullness, and vertigo lasting one to eight hours Diagnosis is made clinically Most commonly caused by too much inner ear endolymph and increased pressure within the inner ear Treatment is low salt diet, diuretics (HCTZ + triamterene) Example: A patient complains of […]
There are two ways of spreading light: to be the candle or the mirror that reflects it. -Edith Wharton Welcome back to Episode 26! Remember to listen for a trauma ring tone and if you hear one send us the time via email or tweet us @Roshcast with the time you hear it. This week, […]
Osgood-Schlatter Disease Patient will be a boy athlete 10–15 years old Complaining of knee pain while running PE will show tenderness over the tibial tubercle Treatment is ice, NSAIDs, quadriceps stretching Example: A 12-year-old boy presents to his pediatrician’s office for right knee pain that started three months ago after starting basketball practices. On physical exam, […]
Patient will be complaining of proximal muscle weakness, ptosis, and diplopia that is worse at the end of the day PE will show ice test improves sx Diagnosis is made by edrophonium (tensilon) test, EMG Most commonly caused by autoimmune destruction of acetylcholine receptors Treatment is acetylcholinesterase inhibitors, such as pyridostigmine Comments: associated with thymoma Example: A 28-year-old […]
Multiple Myeloma Patient will be elderly Complaining of back pain PE will show CRAB: hyperCalcemia, Renal insufficiency, Anemia, lytic Bone lesions/Back pain Labs will show monoclonal antibody spike X-ray will show lytic lesions Peripheral blood smear: Rouleaux formations Serum protein electrophoresis: M spike Protein electrophoresis urine analysis: Bence-Jones proteins Most commonly caused by single clone plasma cell […]
Molluscum Contagiosum Patient will be a school-age child Complaining of “warts” PE will show multiple waxy, dome-shaped papules with umbilicated appearance Most commonly caused by poxvirus Treatment is self-limiting
Complex Regional Pain Syndrome Patient will have a history of previous extremity injury or fracture Complaining of light touch causing extreme pain and allodynia (pain felt from a nonpainful stimulus, such as clothes or bed sheets on the skin) Treatment is NSAIDs, gabapentin, sympathectomy
Welcome back to Episode 25 — our silver anniversary episode! It was great connecting with a few listeners recently at SAEM. At the beginning of this week’s episode, we announced a new contest – be the first to tweet to us (@Roshcast) or email (Roshcast@roshreview.com) the exact time in episodes 26-30 that you hear a trauma phone ring tone to win a 30-day subscription to Rosh Review! First, let us get started with a rapid review covering fish poisonings.
Bacterial Tracheitis Patient will be 3–5 years old Complaining of high fever, barky cough, stridor Treat as airway emergency! Comments: Patient will look like croup but toxic appearing Sample Question: A 3-year-old boy presents in severe respiratory distress. His mother informs you that he has been ill for the last five days, initially with a low-grade fever and […]
Absence Seizures Patient will be a 5–10 years old Complaining of sudden mental status alteration without motor activity or a blank stare EEG during an event would show symmetric 3 Hz spike and wave activity Treatment is ethosuximide Comments: There will be no aura or postictal state