Clinical Year

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

Bacterial Tracheitis Patient will be 3–5 years old 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 “barky cough.”  read more…

Absence Seizures Patient will be a 5–10 years old 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

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Causes: adhesions (pelvic surgery) > tumor > hernia (inguinal) Proximal: bilious vomiting  Distal: feculent vomiting High pitched bowel sounds X-ray: dilated bowel, air-fluid levels, “stack of coins” or “string of pearls” sign Modality of choice: CT NGT, surgery

Appendicitis Patient will be complaining of fever, pain that began periumbilical then moved to RLQ, nausea and anorexia PE will show Psoas sign (RLQ pain on extension of right hip), Obturator sign (RLQ pain on internal rotation of flexed right hip), Rovsing sign (right lower quadrant pain when the left lower quadrant is palpated) Diagnosis is made by ultrasound, CT Most commonly caused read more…

Today’s teaching image and Rapid Review covers cardiac tamponade. Pericardial Tamponade Patient will be complaining of dyspnea and chest pain PE will show muffled heart sounds, JVD and hypotension (Beck’s triad), pulsus paradoxus  ECG will show low voltage QRS, electrical alterans Echocardiography will show diastolic collapse of RV Treatment is pericardiocentesis For more teaching images, try read more…

Today’s teaching image and Rapid Review covers tinea versicolor. Tinea Versicolor Malassezia furfur Patches with altered pigmentation Torso Affected skin does not tan Selenium shampoo For more teaching images, try a free trial of our board review qbanks.

Today’s teaching image and Rapid Review covers basilar skull fracture. Basilar Skull Fracture Petrous portion of temporal bone fracture most common Battle’s sign, raccoon eyes, hemotympanum, CSF otorrhea/rhinorrhea CN VII, VIII entrapment CT For more teaching images, try a free trial of our board review qbanks.