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I heard a snap! Clay Shoveler’s Fracture

In All Posts, Medical Concepts by Andrei SmarandacheLeave a Comment

Reginald, a 73-year-old man, presents to your Emergency Department with neck pain. He tells you that last night he was straining to lift a heavy box. He heard and felt a snap in his neck. This morning, he awoke with neck pain, dizziness, and mild confusion. You examine Reginald and find that he has pain with neck rotation, flexion, and extension. He also has exquisite, sharp tenderness on palpation over the C6 vertebrae. …

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When and how to treat hyponatremia in the ED

In Clinical Questions, Medical Concepts by Andrei SmarandacheLeave a Comment

Electrolyte imbalances like hyponatremia can be the cause of a variety of vague complaints. At the same time, patients may present with electrolyte abnormalities that are asymptomatic and are incidental findings on bloodwork. Here’s an approach to deciding when and how to treat hyponatremia in the emergency department. We also thank Drs. Joel Topf (@kidney_boy) and Dr. John Neary (@jddneary) for their valuable input on this article! The Case Marjorie, an 83-year-old female, …