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A 14-Year-Old Boy With Progressive Weakness and Dyspnea |
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Friday, 10 October 2008 |
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BACKGROUND
A 14-year-old boy presents to the ED with a 10-day history of progressive weakness following symptoms of an upper respiratory infection. The patient’s weakness is affecting his extremities, and he has developed shortness of breath and difficulty urinating. The patient is sent for magnetic resonance imaging (MRI) of his brain and spine.
What is the patient’s condition as verified by the MRI?
CASE DISCUSSION
Click here for the answer and discussion
HINT
Look closely at the cauda equina on the MRI images.
Click here for information on submitting a case
Authors:
Danielle D. DeCourcey, MD, Attending, Medicine Critical Care Program,
Department of Medicine, Children's Hospital Boston; Instructor of
Pediatrics, Harvard Medical School, Boston, MA
Mark Wainwright, MD, PhD, Pediatrics (Neurology), Center for Interdisciplinary Research in Pediatric Critical Illness and Injury (CIRPCII), Northwestern University, Children’s Memorial Hospital, Chicago, IL
Jason M. Kane, MD, Assistant Professor of Pediatrics, Pediatric Critical Care Medicine, Cardiac Intensive Care, Children's Memorial Hospital, Northwestern University, Feinberg School of Medicine, Chicago, IL
eMedicine Editors:
Erik D. Schraga, MD, Clinical Instructor of Emergency Medicine,
Stanford/Kaiser Emergency Medicine Residency Program, Department of
Emergency Medicine, Kaiser Permanente, Santa Clara Medical Center, Santa Clara, CA
Jeffrey C. Wagner, MD, Assistant Clinical Professor, Department of Neurology, University of Utah, Salt Lake City, UT
S. A. Jamal Bokhari, MD, Associate Professor of Radiology - Yale University School Of Medicine. Section Chief Emergency Radiology, Assistant Program Director Radiology Residency - Yale New Haven Hospital, New Haven, CT
Rick G. Kulkarni, MD, FACEP, Assistant Professor, Yale School of
Medicine, Section of Emergency Medicine, Department of Surgery, Attending Physician, Medical Director, Department of Emergency Services, Yale-New Haven Hospital, CT
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Lightheadedness in an Elderly Man |
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Thursday, 18 September 2008 |
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An 80-year-old man is referred for a preoperative cardiac risk assessment. The patient has experienced periodic lightheadedness and has some exertional shortness of breath, as well as a history of COPD.
The lightheadedness occurs without warning and without any identifiable
precipitating factor, and it abates without intervention. An ECG is
obtained while the patient experiences an episode of lightheadedness.
What rhythm does the first portion of the ECG demonstrate?
CASE DISCUSSION
Click here for the answer and discussion
HINT
Note the association between the P waves and each QRS complex.
Click here for information on submitting a case
Authors:
Ryland P. Byrd, Jr, MD, Chief of Pulmonary Medicine, Medical Director of Respiratory Therapy, Quillen Mountain Home Veterans Affairs Medical Center, Professor, Department of Internal Medicine, Division of Pulmonary Diseases and Critical Care Medicine, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, TN
Ehab S. Kasasbeh, MD, Clinical Fellow, Division of Cardiovascular
Medicine, Department of Internal Medicine, Vanderbilt University,
Nashville, TN
Jonathan W. Burress, DO, FACC, Staff Physician, Cardiovascular Associates, Bristol Regional Medical Center, Bristol, TN
eMedicine Editors:
Rick G. Kulkarni, MD, FACEP, Assistant Professor, Yale School of
Medicine, Section of Emergency Medicine, Department of Surgery, Attending Physician, Medical Director, Department of Emergency Services, Yale-New Haven Hospital, CT
Erik D. Schraga, MD, Clinical Instructor of Emergency Medicine,
Stanford/Kaiser Emergency Medicine Residency Program, Department of
Emergency Medicine, Kaiser Permanente, Santa Clara Medical Center, Santa Clara, CA
Alan R. Morrison, MD/PhD, Cardiology Fellow, Yale-New Haven Hospital, New Haven, CT
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Last Updated ( Thursday, 18 September 2008 )
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Insidious Swelling in the Neck of a 45-Year-Old Man |
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Thursday, 04 September 2008 |
BACKGROUND
A 45-year-old man complains of gradual swelling in his neck over the past 6 months; he has a nontender, nonerythematous, fluctuant mass in the midline of the lower neck. He has not experienced any pain, fevers, difficulty swallowing, or alteration of his voice
What is the diagnosis?
CASE DISCUSSION
Click here for the answer and discussion
HINT
This is the most common congenital anomaly resulting in a midline neck mass.
Click here for information on submitting a case
Authors:
Pramod Gupta, MD, Staff Physician, Department of Radiology, Dallas VA Medical Center, Dallas, Texas
Jitendra Gohil, MD, Staff Physician, Department of Radiology, Dallas VA Medical Center, Dallas, Texas
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Food Impaction in a 33-Year-Old Man |
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Thursday, 28 August 2008 |
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BACKGROUND
A 33-year-old man presents to the ED after eating lunch complaining
of “food stuck in my esophagus.” For the last few months, the patient
has been experiencing worsening dysphagia;
he has had problems with swallowing solid food since childhood. The
patient is diagnosed with an esophageal foreign-body obstruction and
treated in the ED with intravenous fluids and glucagon. Two hours after this initial treatment, his symptoms persist.
What condition is revealed on the endoscopic images?
CASE DISCUSSION
Click here for the answer and discussion
HINT
The patient’s history of allergies and his young age are significant to this condition.
Click here for information on submitting a case
Authors:
Juan Carlos Munoz, MD, Clinical Assistant Professor of Medicine,
Department of Gastroenterology, University of Florida, Jacksonville, FL
Carmela Monteiro, MD, Associate Professor, Department of Pathology
and Laboratory Medicine, University of Florida College of
Medicine-Jacksonville, Jacksonville, FL
Ivan E. Rascon-Aguilar, MD, Fellow, University of
Florida/Jacksonville College of Medicine, Department of Internal
Medicine, Division of Gastroenterology, Jacksonville, FL
eMedicine Editors:
Rick G. Kulkarni, MD, FACEP, Assistant Professor, Yale School of
Medicine, Section of Emergency Medicine, Department of Surgery, Attending Physician, Medical Director, Department of Emergency Services, Yale-New Haven Hospital, CT
Tomasz Guzowski, MD, FRCPC, Internal Medicine and Gastroenterology, Stanton Territorial Hospital, Yellowknife, Canada; Assistant Professor of Medicine, University of Alberta
Erik D. Schraga, MD, Clinical Instructor of Emergency Medicine,
Stanford/Kaiser Emergency Medicine Residency Program, Department of
Emergency Medicine, Kaiser Permanente, Santa Clara Medical Center, Santa Clara, CA
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