Lauren Murphy, MD

Advanced Practice: Pearls for Myasthenia Gravis Intubations

Whereas the dosing of sedative medications is usually unaffected, the chief concern is whether there should be changes for neuromuscular blockade – will your patient with myasthenia gravis require a higher or lower dose of your selected paralytic?

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#EMconf: The (Dis)Utility of the Urine Drug Screen

The Urine Drug Screen (UDS) is a commonly used test in the emergency department, however there are many shortcomings that limit its diagnostic utility. The Urine Drug Screen is exactly that – a SCREENing and not a confirmatory test!  This week Dr. Lauren Murphy educated us on: 1) the potential false positives and negatives of the UDAS and 2) the detection times that drug metabolites are at a concentration in the urine to trigger a positive result (cutoff value).  Read ahead for the reference tables!    

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Back to the Basics: Poison Ivy (Toxicodendron) Dermatitis

As the weather becomes nicer, more people are venturing outside to work on their yards, hike and just take in the sun - and hence, more people are becoming exposed to poison ivy, oak, and sumac.  Learn the basic management for toxicodendron dermatitis. 

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Chvostek’s Sign + Hypocalcemia

Chvostek’s sign is momentary contraction of the nose and/or lips in response to tapping the facial nerve at the angle of the jaw.  Associated with hypocalcemia, it has been found to be poorly sensitive and specific.  It is seen in 10-25% of healthy individuals with normal calcium levels, whereas approximately one third of patients with hypocalcemia will not demonstrate this sign.

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What's the Diagnosis? Case by Lauren Murphy

2 year-old male with no PMHx is brought to the ED for intermittent abdominal pain for the past two days. Mom notes that the child will crouch down into a ball when he has pain, which only lasts for a few minutes at a time. He has decreased solid food intake but no vomiting or diarrhea and is otherwise well. Vitals and physical exam are unremarkable. The ultrasound is shown below…what’s the diagnosis?

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