By George Nassar, MD PGY-4 Inova Fairfax Hospital 14 yo F h/o HbSS presenting with 1.5 weeks of chest pain associated with non-bloody, occasionally bilious emesis. Chest pain (CP) is intermittent and was improving with oxycodone 5mg until today. Discharged from inpatient hospitalization for pain crisis just before this pain came on. Described as sharp […]
Author: Harrison Hayward
Hot Seat #203: 28do with abnormal movement
The patient is a 28 day old ex-FT female presenting with abnormal movement. When the patient was waking up from sleep this AM, parents noted a period of bilateral upper extremity stiffening and foaming at the mouth with associated R sided head deviation and eyes rolling back. The episode lasted < 1 min. Patient was […]
Hot Seat #201: A 2-year-old with puffy eyes
By Dr. Christina Rojas, Children’s National Medical Center You start an overnight shift and got sign out on a 3 y/o female with sickle cell anemia (HbSS) who presented with fever, puffy eyes, and bilateral extremity pain. Fever developed this morning, Tmax 38.5. Puffy eyes started yesterday. Extremity pain is bilateral in all four extremities […]
Hot Seat #199: A Tribulation of Tonsils
23mo presents with increased WOB in the setting of 1 day of fever (tmax 101.5) and URI symptoms. Mom noticed some mild swelling of the right side of his neck. No vomiting or diarrhea. Normal PO intake. Normal UOP. Mother reports snoring and chronic nasal congestion at baseline. PMHx: Wheezing in setting of previous illness, […]
Hot Seat #197: 13-year-old with knee pain
13-year-old female initially presented with right knee pain 2 weeks ago and had an X-ray that showed a distal femoral epiphyseal lesion. She then had an outpatient interventional radiology-guided biopsy of it 6 days prior to today. The patient reports her pain was controlled well initially. However, over the last 24 hours, she has had […]