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.
Lauren Murphy, MD
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.
Answer: False. Infants present with non-bilious vomiting
Diagnosis: Pyloric Stenosis
Pathology: Pyloric stenosis is hypertrophy and hyperplasia of the pylorus with a multifactorial inheritance in families. The incidence is 5/1000 births in males and 2/1000 births in females. It is therefore more common in males; it is also more common in first-born infants, and in Caucasian infants.
Case: A six week-old previously healthy, term infant via vaginal birth is brought to pediatric ED for repeated episodes of vomiting over a one week period. Vomiting occurs 20-30 min following every episode of feeding and is described as projectile. Parents note decreased urine output over the past two days. Patient is noted to be hungry following vomiting episodes
Case: A 2 year-old male with no significant PMH is brought to the Emergency Department by his mother 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 lasts only a few minutes at a time. He has decreased solid food intake but no vomiting or diarrhea and is otherwise well.
Case: A 74 yo male patient with a PMH significant for rectal carcincoma (s/p chemotherapy and radiation; refused surgery) arrives with chief complaint of rectal pain and general malaise for two week duration. He notes urinary and fecal incontinence over this same time period. He also notes intermittent fevers.
Case: A 42 year old female patient with a past medical history significant for diabetes, obesity and hypertension presents to the ED with chief complaint of 4 days of abdominal pain.
Case: 55 year old female with unknown medical history presents to the Emergency Department by EMS after having a seizure. Prior to the seizure the patient was found "acting strangely" and agitated outside on her street. Patient had a witnessed seizure after police arrived.