Busy

Hi,

I usually try to plan ahead, but I haven't been so great about it. I'm attending in the ICU this week, and looking at the census - including someone who survived 65 minutes of compressions and 20 defibrillations - I don't think I'll get around to writing cases of the day. I'll try but if not, I'll be back next week.

Craig

Echo

You are passing by the critical care unit when you see the intensivist performing an ultrasound at the bedside of a patient. The ultrasound appears to be positioned in the midline, upper abdomen. The patient is an older patient with congestive heart failure who presented with septic shock from urinary tract infection.

Challenge: What is the intensivist doing?

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Avogadro

This 40 year old woman presented with severe nausea and vomiting. She also notes pelvic discomfort and vaginal bleeding the color of "prune juice." Her heart rate is 104, blood pressure is 152/91. She has a mild tremor. Her urine dipstick shows 1+ protein. Her hCG is quite elevated. Her TSH is low.

Challenge: What is this disease, first described by Hippocrates in 400BC?

Teenagers (Sigh)

A high school football player gets in trouble for tackling players head-on. On lateral view of the neck in neutral alignment, you note developmental narrowing of the cervical spine canal as well as straightening of the normal cervical lordotic curve.

Challenge: What is this injury, first described in 1993?

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Board Exam this Week

The next in a never-ending series of tests happens this week for me. I'm going to be out of town taking my oral board exams, so next case will be a week for now. Thanks for reading.

Craig

Glow in the Dark

You are in a emergency exploratory laparotomy for a patient who developed peritonitis. Half way through running the bowel, the surgeon asks the anesthesiologist to give fluorescein. He then asks the circulator to pull this device out of the closet.

Challenge: What is it and what's he looking for?

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