This week we highlighted a case of headache with an abnormal neurologic exam. We discussed that the patient would not meet the criteria for a Code Stroke given the patient presented >24 hours from symptom onset and therefore was outside the window for TPA therapy. All learners were concerned for an intracranial process, possibly an […]

Case by Chidimma Acholonu MD, CNH PEM Fellow A 13 yo M, previously healthy male presents with 1 week of cough and congestion with 2 days of worsening headache. He initially presented to an urgent care for occipital headache and URI symptoms. He tested negative for COVID and Flu at that time and was discharged. […]

This week we highlighted a case of persistent emesis without diarrhea. The differential for persistent emesis is broad and can be difficult to parse out. The crux of the decision is to determine how much emesis is too much and what portion of the work-up should be completed in the emergency department In this specific […]

Case by Alicia Rolin MD, CNH PEM Fellow 10-year-old previously healthy male presenting with 10 days of non-bloody, non-bilious emesis. Reports 7-10 episodes of emesis per day. Initially only after eating, but now spontaneously throughout the day. Not worse in the AM. No diarrhea. Intermittent 8/10 dull non-radiating epigastric abdominal pain. No identifiable trigger. Does […]

This week’s case highlights the presentation of a 14 yo M with stable asymptomatic hypoxia. Fellows noted that polycythemia on the initial CBC could be secondary to chronic hypoxia. CXR appeared overexpanded with air bronchograms with possible small RLL consolidation and prominent hilum L>R with asymmetric vasculature. Fellows brought up if his pulse ox had […]