The Morning Report

The Best in FOAM Education

August 30, 2019

A 50 year old female presents to the ED for a spot in her vision. She woke up with an “ink splotch” in her right eye, located just off the center of her vision. She is sent from urgent care for ophthalmology evaluation. She denies pain, trauma, flashes, and floaters. She endorses intermittent headac...

August 26, 2019

A 45-year-old generally healthy female presents with 2 days of pain, swelling, redness, and a sensation of tightness around the right index fingertip. She admits to biting her nails often, and notes that her symptoms seemed to develop after she “went after a hangnail pretty aggressively” last week.

...

A 19 year old male presents with two weeks of non-bloody, non-bilious vomiting and two episodes of non-bloody diarrhea. He is unable to eat but is tolerating fluids. His urine is dark and he is febrile to 101.7. He was seen the day before in the ED, discharged with the diagnosis of gastroenteritis,...

August 19, 2019

A 5 year old female with a PMH of chronic suppurative otitis media with bilateral tympanostomy tubes presents with left ear pain and blood tinged otorrhea from her left ear. She had been swimming in a pool for the past 4 days without ear plugs while on vacation. She is non-toxic appearing, afebrile,...

August 17, 2019

Should You?

Indications: 

  • Suspicion of septic arthritis

  • Suspicion of crystal induced arthritis

  • Evaluating if laceration violated joint space

  • *Therapeutic (to relieve pressure or inject steroid/anesthetic)

(Relative) Contraindications:

  • Overlying infection

  • Coagulopathy

  • ...

August 15, 2019

A 27 year old woman G3P2 presents with active vaginal bleeding. She has saturated multiple pads and is bleeding through her pants in triage.

Triage vital signs are HR:115, BP: 100/64, RR: 20, Temp: 37 C.

She is swiftly placed on the monitor, IV access is obtained, and labs are drawn. A pelvic exam re...

A 70 year old M with a past medical history of ILD presents to PCP after one week of fever (TMax: 106 F), malaise, dizziness, epigastric pain, dyspnea, myalgias, diaphoresis, chills, poor appetite. According to daughter, he found a tick on himself just before the symptoms started. He was started emp...

August 9, 2019

A 56 y/o male is found in cardiac arrest by his wife. She calls 911. CPR is initiated. Pulseless electrical activity (PEA) is the only rhythm throughout the resuscitation. Finally, ROSC is achieved and the patient is placed on norepinephrine at 30mcg/min, epinephrine at 30 mcg/min and vasopressin at...

August 7, 2019

A 23-year-old male with developmental delay and seizure disorder with G-tube dependence is being evaluated in the ED for ankle swelling. He has been waiting for a while before getting into his room and now his seizure medications are due. His caretakers brought his seizure medications but realized h...

August 6, 2019

Pericarditis is an inflammation of the parietal or visceral layers of the heart. It has many causes, can mimic many conditions, and requires early diagnosis for prompt treatment in order to avoid long term sequelae.

How does it present?

  • Sharp/pleuritic chest pain

  • Radiates to back or shoulders

    ...
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