A 45 year-old male with no medical history presents with Right knee pain after a mechanical fall causing him to land onto his right knee. Exam reveals moderate swelling and tenderness. He is unable to extend the knee.
Everyone has seen the long list of causes of an anion gap metabolic acidosis. Why review it again? Because one day, whether in real life (or on your board exams...), thinking through this list will help make a tricky diagnosis. It is 'back to basics,' after all!
We encounter patients with upper GI bleeding frequently. While some of these are obviously ill and in need of urgent intervention and/or admission, others appear well and we might consider sending them home - but how do we decide who is low risk enough to discharge? Is there an evidence based approach to risk stratify patients with upper GI bleeds?
Asthma is one of the most common causes of respiratory distress seen in the emergency department. Most often, our patients will get better with some nebulizers and steroids. But when this fails, treatment becomes more complicated and patients can decompensate quickly. What are your options to step up therapy in your most severe asthma cases?