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Source: The Case Files
Condition: Thrombosis
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Total 8 results found since Jan 2013.
A Serious Diagnosis Lacking Common Symptoms
BY JENNIFER TUONG; IVAN KHARCHENKO; JEAN LUC AGARD; & AHMED RAZIUDDIN, MDA 65-year-old man who had HIV well-controlled with highly active antiretroviral therapy, hypertension, sciatica, and restless leg syndrome presented to the emergency department with left leg pain. He also had had chemotherapy and radiation for anal cancer. The patient said the pain had started 45 minutes earlier when he was sitting on the toilet.He described the pain as sore in quality and 10/10 on the pain scale. He reported that it had started in his lower back and radiated to his left leg. He said he had had no trauma or weakness to the regi...
Source: The Case Files - May 28, 2019 Category: Emergency Medicine Tags: Blog Posts Source Type: research
Fool Me Once: An Uncommon Presentation of PE
BY FREDDIE IRIZARRY-DELGADO; VAROON KAKAIYA; & AHMED RAZIUDDIN, MDAn 86-year-old African-American woman was brought to the ED by her daughter after two days of nutritional neglect, abdominal pain, and altered mental status. Her daughter said her mother felt lightheaded, appeared dehydrated, and vomited nonbilious watery fluid once. The patient had a history of diabetes mellitus type 2, DVT/PE, dementia, and early signs of parkinsonism.Her vital signs were remarkable only for tachypnea (24 bpm). Her troponin I was markedly elevated at 1.7 ng/mL. A D-dimer was ordered because of her history of unprovoked DVT/PE, and i...
Source: The Case Files - November 27, 2018 Category: Emergency Medicine Tags: Blog Posts Source Type: research
A True Hematologic Emergency
BY GREGORY TAYLOR, DO, & JACKLYN MCPARLANE, DOA 33-year-old woman with a past medical history of sickle cell SS presented to the emergency department with chest pain, difficulty breathing, and a cough for two days. Her chest pain was diffuse, without radiation, and partially reproducible. Her cough was nonproductive, and she also reported fever and chills.The patient noted this was different from her normal back and leg pain from past sickle cell crises. She was following up with a sickle cell specialist, and was compliant with her hydroxyurea treatment.Her temperature was 102.8°F, blood pressure was 94/60 mm...
Source: The Case Files - June 26, 2018 Category: Emergency Medicine Tags: Blog Posts Source Type: research
Severe Symptoms, but a Truly Treatable Disease
BY NOURA MAHDI; DARRON LEWIS; JEREMY OSBORNE; & AHMED RAZIUDDIN, MDA 73-year-old man was brought to the emergency department from his nursing home for rectal bleeding and anemia. The patient mentioned he had had episodes of bright red rectal bleeding and constipation for a few months. A colonoscopy had been done prior to the visit, which revealed a large intestine tumor and biopsy confirming adenocarcinoma. He was awaiting an appointment with his surgeon.The patient reported bloody rectal leakage, and a CBC done at the nursing home showed a hemoglobin level of 7.2. He also complained of dyspnea but denied any other ...
Source: The Case Files - March 20, 2018 Category: Emergency Medicine Tags: Blog Posts Source Type: research
Not as Simple as Canker Sores
BY NANA P. MATSUMOTO, & DEREK MEEKS, DOA 16-year-old boy presented to a rural ED with a swollen jaw, painful blisters in the mouth, and earache for the past day. One week before, he had a fever with chills, sore throat, and dry coughs. He was not taking any medications, and his immunizations were up-to-date. He had a mild learning disorder but no significant past medical or surgical history.An apthous ulcer, the most common and one of the earliest signs of Behçet's disease.The patient's vital signs were within normal limits, and his physical examination revealed anterior cervical lymphadenopathy, sinus con...
Source: The Case Files - October 11, 2017 Category: Emergency Medicine Tags: Blog Posts Source Type: research
The Case Files: Unusual Headache
By Al-Hashimi, Siddhartha DO; Leavens, John MD
A 23-year-old woman with a history of migraine headaches presented to the emergency department for a different-than-usual headache. She had a six-day history of intermittent headaches. The onset was at rest, and there was no history of trauma.
The headache was located behind her left eye, and it radiated into the posterior portion of her head. She characterized it as being 8/10 in intensity. Bright lights were reported as an exacerbating factor. The headache was associated with nausea and multiple episodes of emesis. She had 10 episodes of vomiting the evening prior to arri...
Source: The Case Files - June 5, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: research
The Case Files: Traumatic Carotid Dissection
By Hsiao, Jonie MD
A 30-year-old man who was right-hand dominant presented 10 days after sustaining left-sided face and head trauma from a fall from a skateboard at an unknown speed. He lost consciousness for several seconds, and initially developed a headache with nausea and vomiting. A non-contrast head CT performed at another hospital done two days after the incident was reportedly negative.
He now presents primarily with concerns about the appearance of his left eye. He has notable anisocoria and a droopy eyelid. His left pupil is notably smaller, 2 mm, compared with the right eye, 5 mm. Both are reactive. The re...
Source: The Case Files - June 4, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: research
