Internal Medicine

Critical Cases - Back Pain Nightmare Diagnosis!

A 44 yo male who works as a construction worker presents with 2 days of lower back pain. Having seen literally hundreds of cases of benign musculoskeletal pain in the last year, you are pretty sure you can handle one more. But is there danger lurking behind this well appearing patient with normal vitals? Well, yes of course. Otherwise we wouldn't be covering it on EM Daily....

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Back to Basics: Fever, Cough, SOB

A patient comes into the ED with a high fever, shortness of breath, mild headache, diarrhea, and general malaise. It’s 2021… so naturally, the ‘COVID alarms’ start sounding in our heads. But if it were that simple, we probably wouldn't be posting about it, would we?

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Critical Cases - Thyrotoxic Periodic Paralysis

A healthy 30 yo male p/w cc of generalized weakness and pain for several hours. But generalized weakness and pain can be about 2 million things! you bemoan internally as you sign up for the patient. Hang on, what's this? Admitted previously for severe, unexplained hypokalemia? The plot has thickened....

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Critical Cases - Spine Emergency!

Back pain. A chief complaint generally not considered among the top 5 most thrilling for EM docs. Hiding among a sea of benign musculoskeletal conditions, however, lurk a handful of diagnoses which will result in irreversible paralysis and severe loss of function for our patients. The trick, of course, is figuring out who needs expensive advanced imaging and who can go home with on for a case that definitely falls into the former category....

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