John Cafaro MD

Board Review: OB/GYN

A 29-year-old woman presents for heavy vaginal bleeding. She is hemodynamically stable. She had an uncomplicated vaginal delivery of a full-term baby 1 week ago. She denies fever or pain. There is active bleeding from the os. No cervical motion tenderness or signs of trauma or foul-smelling discharge. What is the most likely diagnosis? 

A. Uterine Atony

B. Retained products of conception

C. Cervical Trauma

D. Endometritis 

 

 

 

 

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Advanced Practice: Supportive Management of Critical Illness in Pregnancy

The nurse calls you to the room of a 34 year old crashing patient....and she happens to be pregnant.  Here are the pearls for resuscitation and management of the critically ill pregnant patient. 

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Board Review: Aortic Dissection

A 63 year-old female presents to the Emergency Department with sudden onset chest pain that is tearing to the back. Blood pressure is 200/110 and the patient looks very uncomfortable. You order a CTA of the Chest, Abdomen and Pelvis and diagnose Aortic Dissection. What is the medication of choice in the initial management of aortic dissection in this patient?

A. Nitroprusside

B. Nicardipine

C. Esmolol

D. NItroglycerin

E. Diltiazem 

 

 

 

 

 

Answer is C: Esmolol

 

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Back to Basics: Infantile Botulism

This post was inspired by a recent clinical case in our department. A 7 week full term infant s/p spontaneous vaginal delivery with a normal maternal prenatal screen and course presents to your ED for not eating x 12 hours. On exam, you note decreased spontaneous movements, a weak suck and a weak cry noted. Vitals are normal. What's the diagnosis? 

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