You’re working in the ICU overnight and are having difficulty obtaining a blood pressure for a patient that was just transferred to your facility for septic shock secondary to pneumonia. You make the decision to place an arterial line. You place the line sterilely using seldinger technique and connect it to the monitor. Your hard work paid off and you are rewarded with a waveform.
Courtney Martin, DO
You are working at a tertiary care center and a 55-year-old woman is transferred to you from an outside hospital for severe persistent thrombocytopenia of unknown origin. On arrival, she is mildly confused and tachycardic. The platelet count is 7K and the hemoglobin is 5.8. Peripheral blood smear demonstrates schistocytes consistent with microangiopathic hemolytic anemia. The diagnosis of thrombotic thrombocytopenic purpura (TTP) is suspected. TTP is a hematologic emergency: what are the next steps in management?
55 year old female presenting with left knee pain after a fall. Patient appears intoxicated and states she tripped and fell. No preceding symptoms or head trauma. Pain is 5/10. She has not been able to ambulate since the incident. On exam the patient is neurovascularly intact.
19-year-old male with past medical history significant for seizures presents with right shoulder pain. He woke up from sleep with the pain. It is 10/10 and worse with movement. He has multiple prior episodes for which he has been treated for in the ED.
Yes we learned most this as a 4th year med student... but sometimes reviewing the basics can remind us of some important details we've forgotten. That's what back-to-basics is for! Here we review different types of intracranial hemorrhages.
· Aka Calcium Pyrophosphate Deposition Disease (CPPD)
o Deposits of calcium pyrophosphate crystals within the joint space-> seen as chondrocalcinosis (calcification of the cartilage) on x-ray
· Affected Groups:
o Age >50 years
o Both genders impacted equally